Emerging Role of Blood-based Biomarkers in Sarcomas

We assess the emerging role of liquid biopsies, particularly circulating tumor DNA (ctDNA), in sarcoma management. Preliminary studies suggest that ctDNA has multiple potential applications including, early detection in patients with cancer predisposition syndromes, diagnosis, prognostication, therapy selection, and monitoring treatment response. Among patients with gastrointestinal stromal tumors, studies have demonstrated the capacity for identification of clinically relevant resistance mutations. In other sarcoma subtypes such as Ewing sarcoma and osteosarcoma, early findings indicate that ctDNA levels might correlate with tumor burden and outcomes, potentially aiding in risk stratification. Clinical utility has not been established for these applications.