Liquid Biopsies - the Clinics and the Molecules

Area of Science:

• Oncology
• Molecular Biology
• Genetics

Background:

• Multiple myeloma is a genetically heterogeneous cancer with multifocal bone marrow and extramedullary disease.
• Single-site bone marrow biopsies can lead to sampling bias, missing crucial tumor subclones.
• Disease progression and treatment can alter molecular profiles and foster treatment-resistant subclones.

Purpose of the Study:

• To highlight the advantages of liquid biopsies over traditional bone marrow biopsies for multiple myeloma.
• To emphasize the comprehensive biological information obtainable through liquid biopsies.
• To underscore the relevance of liquid biopsies for monitoring treatment response and minimal residual disease.

Main Methods:

• Analysis of circulating tumor cells and cell-free nucleic acids (microRNA, cell-free DNA, long non-coding RNA) in peripheral blood.
• Comparison of information obtained from liquid biopsies versus single-site bone marrow biopsies.
• Assessment of liquid biopsies for detecting tumor heterogeneity and treatment resistance.

Main Results:

• Liquid biopsies provide a gentler, more accessible, and repeatable method for biological information retrieval.
• Peripheral blood analysis captures a broader molecular profile, including the entire tumor and extramedullary sites.
• Liquid biopsies enable comprehensive assessment of treatment response and minimal residual disease levels.

Conclusions:

• Liquid biopsies are a necessary advancement for managing genetically heterogeneous diseases like multiple myeloma.
• This approach overcomes the limitations of sampling bias inherent in bone marrow biopsies.
• Liquid biopsies are crucial for personalized treatment strategies and improved patient prognosis by capturing dynamic disease changes.