Role of circulating-tumor DNA analysis in non-small cell lung cancer
Tao Jiang1, Shengxiang Ren1, Caicun Zhou1
1Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, PR China.
Abstract:
The discovery of actionable driver mutations such as epidermal growth factor receptor (EGFR) and microtubule-associated protein-like 4 anaplastic lymphoma kinase (EML4-ALK) and their highly responses to EGFR and ALK tyrosine kinase inhibitors (TKIs) in patients with advanced non-small-cell lung cancer (NSCLC) allowed precise medicine into reality. However, a substantial part of patients still have no sufficient tissue to perform genomic analysis. As a promising noninvasive biomarker and potential surrogate for the entire tumor genome, circulating tumor DNA (ctDNA) has been applied to the detection of driver gene mutations and epigenetic alteration and monitoring of tumor burden, acquired resistance, tumor heterogeneity and early diagnosis. Since precise therapy is a strategy that optimal therapy is decided based on simultaneous tumor genome information, ctDNA, as a liquid biopsy, may help to perform dynamic genetic surveillance. In this paper we will perspectively discuss the biology and identification of ctDNA in the blood of NSCLC patients and its clinical applications in patient management.
Insights
Circulating tumor DNA (ctDNA) analysis offers a noninvasive method for genomic profiling in advanced non-small-cell lung cancer (NSCLC). This liquid biopsy approach aids in precise therapy selection and dynamic patient management.
Area of Science:
- Oncology
- Molecular Biology
- Genomics
Background:
- Precision medicine in advanced non-small-cell lung cancer (NSCLC) relies on identifying actionable driver mutations like EGFR and EML4-ALK.
- Limited tissue availability for genomic analysis poses a challenge in NSCLC patient management.
Purpose of the Study:
- To explore the role of circulating tumor DNA (ctDNA) as a noninvasive biomarker in NSCLC.
- To discuss the biology, identification, and clinical applications of ctDNA for patient management.
Main Methods:
- Review of current literature on ctDNA biology and detection methods.
- Analysis of ctDNA's utility in identifying driver mutations and monitoring NSCLC progression.
Main Results:
- ctDNA serves as a promising surrogate for tumor genome analysis, enabling noninvasive detection of mutations.
- ctDNA facilitates monitoring of tumor burden, acquired resistance, and tumor heterogeneity.
Conclusions:
- ctDNA analysis represents a significant advancement in liquid biopsy for NSCLC, supporting dynamic genetic surveillance.
- ctDNA holds potential for improving patient management through precise and timely therapeutic decisions.
