Sheriff Samran, Saba Maree, Patel Romika, Fisher Georgia, Schroeder Tanja, Arnolda Gaston, Luo Dan, Warburton Lydia, Gray Elin, Long Georgina, Braithwaite Jeffrey, Rizos Helen, Ellis Louise Ann
Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, Sydney, NSW, Australia.
The Daffodil Centre, Sydney, NSW, Australia.
J Exp Clin Cancer Res. 2025 Feb 12;44(1):50. doi: 10.1186/s13046-025-03322-w.
Liquid biopsy (LB) offers a promising, minimally invasive alternative to traditional tissue biopsies in cancer care, enabling real-time monitoring and personalized treatment. Despite its potential, the routine implementation of LB in clinical practice faces significant challenges. This scoping review examines the barriers and facilitators influencing the implementation of liquid biopsies into standard cancer care.
Four academic databases (PubMed, Scopus, Embase, and Web of Science) were systematically searched without language restrictions. We included peer-reviewed articles that were published between January 2019 and March 2024 that focused on the implementation of LB in cancer care or described barriers and facilitators to its implementation. Data relevant to the review objective, including key article characteristics; barriers and facilitators of implementation; and recommendations for advancement or optimisation; were extracted and analysed using thematic and visual network analyses.
The majority of the included articles were narrative review articles (84%), with most from China (24.2%) and the United States (20%). Thematic analysis identified four main categories and their associated barriers and facilitators to the implementation of LB in cancer care: (1) Laboratory and personnel requirements; (2) Disease specificity; (3) Biomarker-based liquid biopsy; and (4) Policy and regulation. The majority of barriers identified were concentrated in the pre-analytical phase, highlighting the lack of standardization in LB technologies and outcomes.
Through a thematic analysis of the barriers and facilitators to LB implementation, we present an integrated tool designed to encourage the standardization of testing methods for clinical practice guidelines in the field.
液体活检（LB）为癌症治疗中传统组织活检提供了一种有前景的、微创的替代方案，能够实现实时监测和个性化治疗。尽管具有潜力，但液体活检在临床实践中的常规应用面临重大挑战。本综述探讨了影响液体活检纳入标准癌症治疗的障碍和促进因素。
系统检索了四个学术数据库（PubMed、Scopus、Embase和Web of Science），无语言限制。我们纳入了2019年1月至2024年3月发表的同行评审文章，这些文章聚焦于液体活检在癌症治疗中的应用，或描述了其应用的障碍和促进因素。使用主题分析和可视化网络分析提取并分析与综述目标相关的数据，包括关键文章特征、实施的障碍和促进因素，以及推进或优化的建议。
纳入的文章大多为叙述性综述文章（84%），其中大部分来自中国（24.2%）和美国（20%）。主题分析确定了液体活检在癌症治疗中应用的四个主要类别及其相关的障碍和促进因素：（1）实验室和人员要求；（2）疾病特异性；（3）基于生物标志物的液体活检；（4）政策和法规。确定的大多数障碍集中在分析前阶段，突出了液体活检技术和结果缺乏标准化的问题。
通过对液体活检实施的障碍和促进因素进行主题分析，我们提出了一种综合工具，旨在鼓励该领域临床实践指南检测方法的标准化。
