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Liquid Biopsies have multifaceted applications in cancer
Figure 10 : Liquid biopsy methods
Liquid biopsies can be used in all stages of diagnosis , monitoring , and follow-up
Source : goetzpartners Research , Created with BioRender . com
Liquid biopsies can be utilised throughout the cancer patient ' s journey . They can be used from screening in asymptomatic patients to detecting minimal residual disease and recurrence post-treatment of cancer . They can aid and influence which other diagnostic tests are required for a patient and minimise unnecessary testing . Furthermore , once the initial diagnosis is confirmed the presence of certain biomarkers , proteins , and genetic changes can be used in risk stratification for prognostic assessment and treatment personalisation as a companion diagnostic . Moreover , they offer many advantages for the patient ; they are less invasive , results are quicker , and regular follow up during and post treatment is less impactful on a patient ’ s life .
Liquid biopsies have different targets and methods
Although there is a wide array of targets that liquid biopsies can identify ; there are 3 primary methods : 1 . CtCells 2 . CtDNA or CtRNA 3 . Tumour-derived extracellular vesicles (“ EV ”)
Figure
11 : Liquid biopsy methods
Source : goetzpartners Research
Different liquid biopsy technologies are showing promise for early diagnosis
CtCells are released from the primary tumour or metastatic sites and then detected in the patients ’ blood as an alternative to traditional biomarkers . They can be used in early diagnosis , prognosis , and follow-up for recurrence . CtDNA and CtRNA are cell-free and can be secreted from active tumour cells or released following tumour cell necrosis . This is easier to isolate , and many molecular liquid biopsy tests are focusing on this . Many tests look for aberrant epigenetic changes regulating cell growth and function . The most common and widely understood of these is DNA methylation . EV are released from all cells ; sequencing can identify mutations in the EV genetic material can distinguish these cancer released EV from physiological EV . Examples include exosomes which are ejected from tumours into the bloodstream . EVs normally have a role in cellular communication and are known to promote tumour
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