Blood-based liquid biopsies for prostate cancer: clinical opportunities and challenges
Cet article passe en revue les différents biomarqueurs issus des biopsies liquides (ADN tumoral circulant, ARN circulant, cellules tumorales circulantes, vésicules extracellulaires, ...), analyse leur utilité dans la prise en charge d'un cancer de la prostate et identifie les défis à relever pour leur utilisation en routine dans le cadre d'un traitement personnalisé
Liquid biopsy has been established as a powerful, minimally invasive, tool to detect clinically actionable aberrations across numerous cancer types in real-time. With the development of new therapeutic agents in prostate cancer (PC) including DNA repair targeted therapies, this is especially attractive. However, there is unclarity on how best to screen for PC, improve risk stratification and ultimately how to treat advanced disease. Therefore, there is an urgent need to develop better biomarkers to help guide oncologists’ decisions in these settings. Circulating tumour cells (CTCs), exosomes and cell-free DNA/RNA (cfDNA/cfRNA) analysis, including epigenetic features such as methylation, have all shown potential in prognostication, treatment response assessment and detection of emerging mechanisms of resistance. However, there are still challenges to overcome prior to implementing liquid biopsies in routine clinical practice such as preanalytical considerations including blood collection and storage, the cost of CTC isolation and enrichment, low-circulating tumour content as a limitation for genomic analysis and how to better interpret the sequencing data generated. In this review, we describe an overview of the up-to-date clinical opportunities in the management of PC through blood-based liquid biopsies and the next steps for its implementation in personalised treatment guidance.
British Journal of Cancer , article en libre accès, 2022