TY - JOUR
T1 - Clinical utility of liquid diagnostic platforms in non-small cell lung cancer
AU - Levy, Benjamin
AU - Hu, Zishuo I.
AU - Cordova, Kristen N.
AU - Close, Sandra
AU - Lee, Karen
AU - Becker, Daniel
N1 - Publisher Copyright:
© AlphaMed Press 2016.
PY - 2016/9
Y1 - 2016/9
N2 - A firmer understanding of the genomic landscape of lung cancer has recently led to targeted, therapeutic advances in non-small cell lung cancer. Historically, the reference standard for the diagnosis and genetic interrogation for advanced-stage patients has been tissue acquisition via computed tomography-guided core or fine needle aspira- tion biopsy. However, this process can frequently put the patient at risk and remains complicated by sample avail- ability and tumor heterogeneity. In addition, the time required to complete the diagnostic assays can negatively affect clinical care. Technological advances in recent years have led to the development of blood-based diagnostics or “liquid biopsies” with great potential to quickly diagnose and genotype lung cancer using a minimally invasive technique. Recent studies have suggested that molecular alterations identified in cell-free DNA (cfDNA) or circulating tumor DNA can serve as an accurate molecular proxy of tumor biology and reliably predict the response to tyrosine kinasetherapy. Inaddition, several trials have demonstrated the high accuracy of microRNA (miRNA) platforms in discerning cancerous versus benign nodules in high-risk, screened patients. Despite the promise of these platforms, issues remain, including varying sensitivities and specificities between competing platforms and a lack of standardization of techniques and downstream processing. In the present report, the clinical applications of liquid biopsy technologies, including circulating tumor cells, proteomics, miRNA, and cfDNA for NSCLC, are reviewed and insight is provided into the diagnostic and therapeutic implications and challenges of these plat-forms.
AB - A firmer understanding of the genomic landscape of lung cancer has recently led to targeted, therapeutic advances in non-small cell lung cancer. Historically, the reference standard for the diagnosis and genetic interrogation for advanced-stage patients has been tissue acquisition via computed tomography-guided core or fine needle aspira- tion biopsy. However, this process can frequently put the patient at risk and remains complicated by sample avail- ability and tumor heterogeneity. In addition, the time required to complete the diagnostic assays can negatively affect clinical care. Technological advances in recent years have led to the development of blood-based diagnostics or “liquid biopsies” with great potential to quickly diagnose and genotype lung cancer using a minimally invasive technique. Recent studies have suggested that molecular alterations identified in cell-free DNA (cfDNA) or circulating tumor DNA can serve as an accurate molecular proxy of tumor biology and reliably predict the response to tyrosine kinasetherapy. Inaddition, several trials have demonstrated the high accuracy of microRNA (miRNA) platforms in discerning cancerous versus benign nodules in high-risk, screened patients. Despite the promise of these platforms, issues remain, including varying sensitivities and specificities between competing platforms and a lack of standardization of techniques and downstream processing. In the present report, the clinical applications of liquid biopsy technologies, including circulating tumor cells, proteomics, miRNA, and cfDNA for NSCLC, are reviewed and insight is provided into the diagnostic and therapeutic implications and challenges of these plat-forms.
KW - Cell-free DNA
KW - Circulating tumor cells
KW - Liquid diagnostics
KW - MicroRNA
KW - Non-small cell lung cancer
UR - http://www.scopus.com/inward/record.url?scp=84987962168&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2016-0082
DO - 10.1634/theoncologist.2016-0082
M3 - Article
C2 - 27388233
AN - SCOPUS:84987962168
SN - 1083-7159
VL - 21
SP - 1121
EP - 1130
JO - Oncologist
JF - Oncologist
IS - 9
ER -