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- Title
Clinical Utility of Liquid Diagnostic Platforms in Non-Small Cell Lung Cancer.
- Authors
Levy, Benjamin; Hu, Zishuo I.; Cordova, Kristen N.; Close, Sandra; Lee, Karen; Becker, Daniel
- Abstract
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 aspiration biopsy. However, this process can frequently put the patient at risk and remains complicated by sample availability 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 kinase therapy. In addition, 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 platforms.
- Subjects
LUNG cancer diagnosis; LUNG cancer prognosis; CELL receptors; COMPUTED tomography; DNA; ENDOSCOPIC surgery; EPIDERMAL growth factor; GENETIC mutation; NEEDLE biopsy; POLYMERASE chain reaction; RNA; TUMOR markers; GENOTYPES
- Publication
Oncologist, 2016, Vol 21, Issue 9, p1121
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2016-0082