Liquid biopsy in ovarian cancer using circulating tumor DNA and cells: Ready for prime time?

Cancer Lett. 2020 Jan 1:468:59-71. doi: 10.1016/j.canlet.2019.10.014. Epub 2019 Oct 11.

Abstract

Liquid biopsies hold the potential to inform cancer patient prognosis and to guide treatment decisions at the time when direct tumor biopsy may be impractical due to its invasive nature, inaccessibility and associated complications. Specifically, circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) have shown promising results as companion diagnostic biomarkers for screening, prognostication and/or patient surveillance in many cancer types. In ovarian cancer (OC), CTC and ctDNA analysis allow comprehensive molecular profiling of the primary, metastatic and recurrent tumors. These biomarkers also correlate with overall tumor burden and thus, they provide minimally-invasive means for patient monitoring during clinical course to ascertain therapy response and timely treatment modification in the context of disease relapse. Here, we review recent reports of the potential clinical value of CTC and ctDNA in OC, expatiating on their use in diagnosis and prognosis. We critically appraise the current evidence, and discuss the issues that still need to be addressed before liquid biopsies can be implemented in routine clinical practice for OC management.

Keywords: Cell-free DNA (cfDNA); Circulating tumor DNA (ctDNA); Circulating tumor cells (CTC); Diagnosis; Ovarian cancer; Prognosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Biomarkers, Tumor / blood*
  • Biomarkers, Tumor / genetics
  • Chemotherapy, Adjuvant
  • Circulating Tumor DNA / blood*
  • Circulating Tumor DNA / genetics
  • DNA Methylation
  • Drug Monitoring / methods
  • Drug Monitoring / standards
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / standards
  • Feasibility Studies
  • Female
  • Humans
  • Liquid Biopsy / methods
  • Liquid Biopsy / standards
  • Mass Screening / methods
  • Mass Screening / standards
  • Neoadjuvant Therapy / methods
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / therapy
  • Neoplastic Cells, Circulating / pathology*
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / therapy
  • Ovariectomy
  • Prognosis
  • Progression-Free Survival
  • Reproducibility of Results

Substances

  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Circulating Tumor DNA