Liquid profiling for cancer patient stratification in precision medicine – current status and challenges for successful implementation in standard care
Circulating tumor DNA (ctDNA), accurately described by the term liquid profiling (LP), enables real-time assessment of the tumor mutational profile as a minimally invasive test and has therefore rapidly gained traction, particular for the management of cancer patients. By LP, tumor-specific genetic...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
De Gruyter
2022-08-01
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| Series: | Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1515/labmed-2022-0066 |
| _version_ | 1811194266458783744 |
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| author | Haselmann Verena Hedtke Maren Neumaier Michael |
| author_facet | Haselmann Verena Hedtke Maren Neumaier Michael |
| author_sort | Haselmann Verena |
| collection | DOAJ |
| description | Circulating tumor DNA (ctDNA), accurately described by the term liquid profiling (LP), enables real-time assessment of the tumor mutational profile as a minimally invasive test and has therefore rapidly gained traction, particular for the management of cancer patients. By LP, tumor-specific genetic alterations can be determined as part of companion diagnostics to guide selection of appropriate targeted therapeutics. Because LP facilitates longitudinal monitoring of cancer patients, it can be used to detect acquired resistant mechanisms or as a personalized biomarker for earlier detection of disease recurrence, among other applications. However, LP is not yet integrated into routine care to the extent that might be expected. This is due to the lack of harmonization and standardization of preanalytical and analytical workflows, the lack of proper quality controls, limited evidence of its clinical utility, heterogenous study results, the uncertainty of clinicians regarding the value and appropriate indications for LP and its interpretation, and finally, the lack of reimbursement for most LP tests. In this review, the value proposition of LP for cancer patient management and treatment optimization, the current status of implementation in standard care, and the main challenges that need to be overcome are discussed in detail. |
| first_indexed | 2024-04-12T00:24:14Z |
| format | Article |
| id | doaj.art-665e5a2274dd483a96455565481b9136 |
| institution | Directory Open Access Journal |
| issn | 2567-9430 2567-9449 |
| language | English |
| last_indexed | 2024-04-12T00:24:14Z |
| publishDate | 2022-08-01 |
| publisher | De Gruyter |
| record_format | Article |
| series | Journal of Laboratory Medicine |
| spelling | doaj.art-665e5a2274dd483a96455565481b91362022-12-22T03:55:35ZengDe GruyterJournal of Laboratory Medicine2567-94302567-94492022-08-0146422523610.1515/labmed-2022-0066Liquid profiling for cancer patient stratification in precision medicine – current status and challenges for successful implementation in standard careHaselmann Verena0Hedtke Maren1Neumaier Michael2Institute of Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, University Hospital Mannheim, Mannheim, GermanyInstitute of Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, University Hospital Mannheim, Mannheim, GermanyInstitute of Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, University Hospital Mannheim, Mannheim, GermanyCirculating tumor DNA (ctDNA), accurately described by the term liquid profiling (LP), enables real-time assessment of the tumor mutational profile as a minimally invasive test and has therefore rapidly gained traction, particular for the management of cancer patients. By LP, tumor-specific genetic alterations can be determined as part of companion diagnostics to guide selection of appropriate targeted therapeutics. Because LP facilitates longitudinal monitoring of cancer patients, it can be used to detect acquired resistant mechanisms or as a personalized biomarker for earlier detection of disease recurrence, among other applications. However, LP is not yet integrated into routine care to the extent that might be expected. This is due to the lack of harmonization and standardization of preanalytical and analytical workflows, the lack of proper quality controls, limited evidence of its clinical utility, heterogenous study results, the uncertainty of clinicians regarding the value and appropriate indications for LP and its interpretation, and finally, the lack of reimbursement for most LP tests. In this review, the value proposition of LP for cancer patient management and treatment optimization, the current status of implementation in standard care, and the main challenges that need to be overcome are discussed in detail.https://doi.org/10.1515/labmed-2022-0066cancer managementcell-free dnacirculating tumor dnaclinical oncologyliquid biopsyliquid profilingpersonalized medicinestandard care |
| spellingShingle | Haselmann Verena Hedtke Maren Neumaier Michael Liquid profiling for cancer patient stratification in precision medicine – current status and challenges for successful implementation in standard care Journal of Laboratory Medicine cancer management cell-free dna circulating tumor dna clinical oncology liquid biopsy liquid profiling personalized medicine standard care |
| title | Liquid profiling for cancer patient stratification in precision medicine – current status and challenges for successful implementation in standard care |
| title_full | Liquid profiling for cancer patient stratification in precision medicine – current status and challenges for successful implementation in standard care |
| title_fullStr | Liquid profiling for cancer patient stratification in precision medicine – current status and challenges for successful implementation in standard care |
| title_full_unstemmed | Liquid profiling for cancer patient stratification in precision medicine – current status and challenges for successful implementation in standard care |
| title_short | Liquid profiling for cancer patient stratification in precision medicine – current status and challenges for successful implementation in standard care |
| title_sort | liquid profiling for cancer patient stratification in precision medicine current status and challenges for successful implementation in standard care |
| topic | cancer management cell-free dna circulating tumor dna clinical oncology liquid biopsy liquid profiling personalized medicine standard care |
| url | https://doi.org/10.1515/labmed-2022-0066 |
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