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Liquid Biopsy in Lung Cancer: Tracking Resistance to Targeted Therapies
Scarlet B Urtecho1,2, Beatriz Jimenez Munarriz1,2, Mary R Rabey1
1Division of Medical Oncology, Princess Margaret Cancer Centre (PMCC), University Health Network (UHN), Toronto, ON M5G 2M9, Canada.
Abstract:
Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related mortality worldwide. While target therapies have changed the outcomes of patients harboring actionable mutations, resistance inevitably emerges. Circulating tumor DNA (ctDNA) offers a minimally invasive tool for capturing tumor evolution in real time. This approach enables the rapid detection of resistance mechanisms, complements or substitutes for tissue re-biopsy, and reduces the burden of invasive procedures for patients. In this review, we summarize the current evidence on the use of liquid biopsy to uncover resistance mechanisms in patients progressing on targeted therapies, with a focus on its role in dynamic tumor profiling and longitudinal disease monitoring.
Insights
Liquid biopsy using circulating tumor DNA (ctDNA) detects resistance mechanisms in non-small cell lung cancer (NSCLC) patients undergoing targeted therapy. This minimally invasive method tracks tumor evolution and aids treatment decisions.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Non-small cell lung cancer (NSCLC) is a major global cancer mortality cause.
- Targeted therapies improve outcomes for NSCLC patients with actionable mutations, but resistance is common.
- Tissue biopsies for resistance detection are invasive and may not capture tumor heterogeneity.
Purpose of the Study:
- To review the evidence for using liquid biopsy to identify resistance mechanisms in NSCLC patients.
- To highlight the role of circulating tumor DNA (ctDNA) in dynamic tumor profiling.
- To emphasize ctDNA's utility in longitudinal disease monitoring.
Main Methods:
- Literature review of studies utilizing liquid biopsy for resistance detection in NSCLC.
- Analysis of ctDNA's role in real-time tumor evolution tracking.
- Evaluation of ctDNA's effectiveness in complementing or replacing tissue biopsies.
Main Results:
- Liquid biopsy via ctDNA analysis enables rapid detection of emerging resistance mechanisms.
- ctDNA profiling provides a comprehensive view of tumor heterogeneity and evolution.
- This approach reduces the need for invasive procedures, improving patient experience.
Conclusions:
- Liquid biopsy is a valuable tool for monitoring NSCLC patients on targeted therapies.
- ctDNA analysis facilitates timely identification of resistance, guiding subsequent treatment strategies.
- Dynamic tumor profiling with ctDNA supports personalized medicine in NSCLC management.
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