Liquid Biopsy in Colorectal Carcinoma: Clinical Applications and Challenges

Drahomír Kolenčík, Stephanie N Shishido, Pavel Pitule, Jeremy Mason, James Hicks, Peter Kuhn, Drahomír Kolenčík, Stephanie N Shishido, Pavel Pitule, Jeremy Mason, James Hicks, Peter Kuhn

Abstract

Colorectal carcinoma (CRC) is characterized by wide intratumor heterogeneity with general genomic instability and there is a need for improved diagnostic, prognostic, and therapeutic tools. The liquid biopsy provides a noninvasive route of sample collection for analysis of circulating tumor cells (CTCs) and genomic material, including cell-free DNA (cfDNA), as a complementary biopsy to the solid tumor tissue. The solid biopsy is critical for molecular characterization and diagnosis at the time of collection. The liquid biopsy has the advantage of longitudinal molecular characterization of the disease, which is crucial for precision medicine and patient-oriented treatment. In this review, we provide an overview of CRC and the different methodologies for the detection of CTCs and cfDNA, followed by a discussion on the potential clinical utility of the liquid biopsy in CRC patient care, and lastly, current challenges in the field.

Keywords: CRC; CTC; cfDNA; circulating free DNA; circulating tumor DNA; circulating tumor cell; colorectal carcinoma; ctDNA; liquid biopsy; precision medicine.

Conflict of interest statement

James Hicks, Clinical Advisory Board, Epic Sciences, Inc. P. Kuhn received stock and dividends, Epic Sciences, Inc. Epic Sciences is evaluating the feasibility of translating the circulating tumor cell (CTC) assay into a commercial format.

Figures

Figure 1
Figure 1
Colorectal carcinoma (CRC) is categorized based on its anatomic location. Right CRC (RCC) is localized in caecum, ascending colon or two proximal thirds of transverse colon. Left CRC (LCC) is defined as CRC in distal third of transverse colon, descending colon, sigmoid colon, or rectum. Clinical applications of the liquid biopsy in CRC include diagnosis, treatment selection, prognostic, and therapy monitoring.

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Source: PubMed

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