Blood liquid biopsy has emerged as a way of overcoming the clinical limitations of repeat biopsy by testing for the presence of acquired resistance mutations to therapeutic agents. Despite its merits of repeatability and non-invasiveness, this method is currently only used as a supplemental test due to a relatively low sensitivity rate of 50%–60%, and cannot replace tissue biopsy. The circulating tumor DNAs used in blood liquid biopsies are passive products of fragmented DNA with a short half-life released following tumor cell death; the low sensitivity seen with liquid blood biopsy results from this instability, which makes increasing the sensitivity of this test fundamentally difficult. Extracellular vesicles (EVs) are ideal carriers of cancer biomarkers, as cancer cells secret an abundance of EVs, and the contents of tumor cell-originated EVs reflect the molecular and genetic composition of parental cells. In addition, EV-derived DNAs (EV DNAs) consist of large-sized genomic DNAs and tumor-specific oncogenic mutant DNAs. For these reasons, liquid biopsy using EV DNA has the potential to overcome issues arising from tissue shortages associated with small biopsies, which are often seen in lung cancer patients, and the biopsy product can be used in other diagnostic methods, such as epidermal growth factor receptor (EGFR) mutation testing and next-generation sequencing (NGS). A higher sensitivity can be achieved when EV DNAs obtained from bronchoalveolar lavage fluid (BALF) are used rather than those from blood. BALF, when obtained close to the tumor site, is a promising liquid biopsy tool, as it enables the gathering of both cellular and non-cellular fractions of the tumor microenvironment, and provides increased diagnostic sensitivity when compared to blood.
Citations
Citations to this article as recorded by
Nanobiotechnology: A smart platform of the future transform liquid biopsy era Srijan Goswami, Palas Samanta, Manab Deb Adhikari The Journal of Liquid Biopsy.2024; 3: 100137. CrossRef
Extracellular Vesicle-DNA: The Next Liquid Biopsy Biomarker for Early Cancer Diagnosis? Irène Tatischeff Cancers.2023; 15(5): 1456. CrossRef
Isolation of extracellular vesicles from human plasma samples: The importance of controls Migmar Tsamchoe, Stephanie Petrillo, Anthoula Lazaris, Peter Metrakos Biotechnology Journal.2023;[Epub] CrossRef
The role of extracellular vesicles in non-small-cell lung cancer, the unknowns, and how new approach methodologies can support new knowledge generation in the field Sive Mullen, Dania Movia European Journal of Pharmaceutical Sciences.2023; 188: 106516. CrossRef
Silicon microfabrication technologies for biology integrated advance devices and interfaces Vuslat B. Juska, Graeme Maxwell, Pedro Estrela, Martyn E. Pemble, Alan O'Riordan Biosensors and Bioelectronics.2023; 237: 115503. CrossRef
Bronchoalveolar Lavage as Potential Diagnostic Specimens to Genetic Testing in Advanced Nonsmall Cell Lung Cancer Xuwen Lin, Yazhou Cai, Chenyu Zong, Binbin Chen, Di Shao, Hao Cui, Zheng Li, Ping Xu Technology in Cancer Research & Treatment.2023;[Epub] CrossRef
In-Cell Labeling Coupled to Direct Analysis of Extracellular Vesicles in the Conditioned Medium to Study Extracellular Vesicles Secretion with Minimum Sample Processing and Particle Loss Anissa Viveiros, Vaibhavi Kadam, John Monyror, Luis Carlos Morales, Desmond Pink, Aja M. Rieger, Simonetta Sipione, Elena Posse de Chaves Cells.2022; 11(3): 351. CrossRef
Recent advances in liquid biopsy in cancers: Diagnosis, disease state and treatment response monitoring Zhixian Chen, Judy Wai Ping Yam Clinical and Translational Discovery.2022;[Epub] CrossRef
Cell-Secreted Vesicles: Novel Opportunities in Cancer Diagnosis, Monitoring and Treatment Cristina Catoni, Veronica Di Paolo, Elisabetta Rossi, Luigi Quintieri, Rita Zamarchi Diagnostics.2021; 11(6): 1118. CrossRef
DNA-Loaded Extracellular Vesicles in Liquid Biopsy: Tiny Players With Big Potential? Susana García-Silva, Miguel Gallardo, Héctor Peinado Frontiers in Cell and Developmental Biology.2021;[Epub] CrossRef
Characteristics and Clinical Application of Extracellular Vesicle-Derived DNA Jae Young Hur, Kye Young Lee Cancers.2021; 13(15): 3827. CrossRef
Bronchoalveolar Lavage as a Potential Diagnostic Specimens to Genetic Testing in Advanced Lung Cancer Xuwen Lin, Xueying Wang, Yazhou Cai, Chenyu Zong, Dawei Liu, Jiming Yu, Chenxin Zhou, Jing Yao, Zheng Li, ping xu SSRN Electronic Journal .2021;[Epub] CrossRef
Multi-Omics Data Integration in Extracellular Vesicle Biology—Utopia or Future Reality? Leona Chitoiu, Alexandra Dobranici, Mihaela Gherghiceanu, Sorina Dinescu, Marieta Costache International Journal of Molecular Sciences.2020; 21(22): 8550. CrossRef
With advances in target therapy, molecular analysis of tumors is routinely required for treatment decisions in patients with advanced non-small cell lung cancer (NSCLC). Liquid biopsy refers to the sampling and analysis of circulating cell-free tumor DNA (ctDNA) in various body fluids, primarily blood. Because the technique is minimally invasive, liquid biopsies are the future in cancer management. Epidermal growth factor receptor (EGFR) ctDNA tests have been performed in routine clinical practice in advanced NSCLC patients to guide tyrosine kinase inhibitor treatment. In the near future, liquid biopsy will be a crucial prognostic, predictive, and diagnostic method in NSCLC. Here we present the current status and future perspectives of liquid biopsy in NSCLC.
Citations
Citations to this article as recorded by
Unlocking the future of cancer diagnosis – promises and challenges of ctDNA-based liquid biopsies in non-small cell lung cancer Chiara Reina, Berina Šabanović, Chiara Lazzari, Vanesa Gregorc, Christopher Heeschen Translational Research.2024; 272: 41. CrossRef
Tailored point-of-care biosensors for liquid biopsy in the field of oncology Sima Singh, Pritam Saha Podder, Matt Russo, Charles Henry, Stefano Cinti Lab on a Chip.2023; 23(1): 44. CrossRef
Emerging role of non-invasive and liquid biopsy biomarkers in pancreatic cancer Akash Bararia, Prosenjeet Chakraborty, Paromita Roy, Bitan Kumar Chattopadhay, Amlan Das, Aniruddha Chatterjee, Nilabja Sikdar World Journal of Gastroenterology.2023; 29(15): 2241. CrossRef
Liquid biopsy in the management of advanced lung cancer: Implementation and practical aspects Gabriela Fernandes, Ana Rodrigues, Cláudia Matos, Fernando Barata, Luís Cirnes, Lurdes Ferreira, José Albino Lopes, Margarida Felizardo, Paula Fidalgo, Ulisses Brito, Bárbara Parente Cancer Treatment and Research Communications.2023; 36: 100725. CrossRef
Tweezer PCR: A Highly Specific Method for Accurate Identification of Low-Abundance Mutations Shanglin Li, Yin Gu, Zhi Geng, Kaiyi Li, Yawei Hu, Qiang Liu, Rongxin Fu, Peng Liu Analytical Chemistry.2023; 95(48): 17679. CrossRef
Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics Hyun Hee Koh, Eunhyang Park, Hyun-Soo Kim Diagnostics.2022; 12(2): 326. CrossRef
Alveolar Soft Part Sarcoma of the Uterus: Clinicopathological and Molecular Characteristics Yurimi Lee, Kiyong Na, Ha Young Woo, Hyun-Soo Kim Diagnostics.2022; 12(5): 1102. CrossRef
Exosomal MicroRNA Analyses in Esophageal Squamous Cell Carcinoma Cell Lines Sora Kim, Gwang Ha Kim, Su Jin Park, Chae Hwa Kwon, Hoseok I, Moon Won Lee, Bong Eun Lee Journal of Clinical Medicine.2022; 11(15): 4426. CrossRef
Molecular biomarker testing for non–small cell lung cancer: consensus statement of the Korean Cardiopulmonary Pathology Study Group Sunhee Chang, Hyo Sup Shim, Tae Jung Kim, Yoon-La Choi, Wan Seop Kim, Dong Hoon Shin, Lucia Kim, Heae Surng Park, Geon Kook Lee, Chang Hun Lee Journal of Pathology and Translational Medicine.2021; 55(3): 181. CrossRef
Update on molecular pathology and role of liquid biopsy in nonsmall cell lung cancer Pamela Abdayem, David Planchard European Respiratory Review.2021; 30(161): 200294. CrossRef
Dynamics of Specific cfDNA Fragments in the Plasma of Full Marathon Participants Takehito Sugasawa, Shin-ichiro Fujita, Tomoaki Kuji, Noriyo Ishibashi, Kenshirou Tamai, Yasushi Kawakami, Kazuhiro Takekoshi Genes.2021; 12(5): 676. CrossRef
Future Perspectives in Detecting EGFR and ALK Gene Alterations in Liquid Biopsies of Patients with NSCLC Daniela Ferreira, Juliana Miranda, Paula Martins-Lopes, Filomena Adega, Raquel Chaves International Journal of Molecular Sciences.2021; 22(8): 3815. CrossRef
Real-World Analysis of the EGFR Mutation Test in Tissue and Plasma Samples from Non-Small Cell Lung Cancer Hyunwoo Lee, Joungho Han, Yoon-La Choi Diagnostics.2021; 11(9): 1695. CrossRef
Objective Quantitation of EGFR Protein Levels using Quantitative Dot Blot Method for the Prognosis of Gastric Cancer Patients Lei Xin, Fangrong Tang, Bo Song, Maozhou Yang, Jiandi Zhang Journal of Gastric Cancer.2021; 21(4): 335. CrossRef
The Role of the Liquid Biopsy in Decision-Making for Patients with Non-Small Cell Lung Cancer D. Akhoundova, J. Mosquera Martinez, L. E. Musmann, C. Britschgi, C. Rütsche, M. Rechsteiner, E. Nadal, M. R. Garcia Campelo, A. Curioni-Fontecedro Journal of Clinical Medicine.2020; 9(11): 3674. CrossRef
Expanding opportunities in precision oncology T Raja Cancer Research, Statistics, and Treatment.2020; 3(4): 863. CrossRef