Liquid biopsy in triple-negative breast cancer: unlocking the potential of precision oncology

ESMO Open. 2024 Oct;9(10):103700. doi: 10.1016/j.esmoop.2024.103700. Epub 2024 Sep 16.

Abstract

In the era of precision oncology, the management of triple-negative breast cancer (TNBC) is rapidly changing and becoming more complicated with a variety of chemotherapy, immunotherapy, and targeted treatment options. Currently, TNBC treatment is based on prognostic and predictive factors including immunohistochemical biomarkers [e.g. programmed death-ligand 1 (PD-L1)] and germline BRCA mutations. Given the current limitation of existing biomarkers, liquid biopsies may serve as clinically useful tools to determine treatment efficacy and response in both the (neo)adjuvant and metastatic settings, for detecting early relapse, and for monitoring clonal evolution during treatment. In this review, we comprehensively summarize current and future liquid biopsy applications. Specifically, we highlight the role of circulating tumor cell characterization, circulating tumor DNA, and other preclinical liquid biopsy technologies including circulating exosomes, RNA liquid biopsy, and circulating immune-based biomarkers. In the near future, these biomarkers may serve to identify early disease relapse, therapeutic targets, and disease clonality for patients with TNBC in the clinical setting.

Keywords: circulating tumor DNA; circulating tumor cells; liquid biopsy; novel biomarkers; precision oncology; triple-negative breast cancer.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor* / metabolism
  • Circulating Tumor DNA
  • Female
  • Humans
  • Liquid Biopsy / methods
  • Neoplastic Cells, Circulating / metabolism
  • Neoplastic Cells, Circulating / pathology
  • Precision Medicine* / methods
  • Triple Negative Breast Neoplasms* / genetics
  • Triple Negative Breast Neoplasms* / pathology
  • Triple Negative Breast Neoplasms* / therapy

Substances

  • Biomarkers, Tumor
  • Circulating Tumor DNA