Unlocking Cancer Insights
A liquid biopsy enables the study of cancer through analtyes circulating in bodily fluids such as blood. Liquid biopsy offers a repeatable, patient-friendly alternative to traditional tissue biopsies. While tissue biopsies are invasive, risky, and often unsuitable for repeated monitoring, a simple blood draw can reveal powerful, real-time insights into a patient’s disease status¹.
Liquid biopsies contain multiple analytes including Circulating Tumor Cells (CTCs), circulating tumor DNA (ctDNA), exosomes, circulating cell-free RNA (cfRNA), proteins and metabolites.
These analytes can provide important information about a patient’s tumor and help to guide a personalized treatment plan; the most established being circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs).
When utilised together these analytes provide additional and complementary information to either one in isolation⁵⁻⁷.
CTCs
CTCs
CTCs are live cancer cells shed from primary or metastatic tumors into the bloodstream and can form metastasis. As intact cells, they closely reflect tumor biology and enable multiomic analysis, offering insights into tumor behavior that may support applications across the cancer care pathway²,³.
ctDNA
ctDNA
ctDNA consists mainly of fragmented DNA released predominantly from dead or dying cancer cells through necrosis or apoptosis⁴,⁵. ctDNA can be used to determine mutation status and monitor treatment resistance or disease progression⁴.
Tissue Biopsy is Challenged By:
- the frequent lack of tissue availability (patient may be too unwell for surgery, tumor inaccessibility, insufficient tissue sampling)
- the dynamic nature of the cancer response to treatment meaning the original biopsy information is rapidly outdated
- tumor heterogeneity as it only samples one site
CTCs Provide a Uniquely Comprehensive View of Cancer Biology
Discover Circulating Tumor Cells
Liquid biopsy - Redefining Precision Medicine
A simple blood draw can provide powerful cancer insights that can be repeated allowing monitoring of a patient’s disease, including changes in their cancer over time.
- It enables targeted therapy by identifying specific, actionable genomic mutations in real-time
- It enables monitoring for recurrence by detecting minimal residual disease (MRD) or emerging resistance mutations long before traditional imaging
Liquid biopsy is a rapidly emerging market and in recent years there has been a strong demand for the integration of liquid biopsies into clinical use. In 2020 the Food and Drug Administration (FDA) approved the use of multiple liquid biopsy tests as a companion diagnostic, where they are used to identify patients that should receive specific targeted therapies.
References
1. Liquid biopsy in cancer: current status, challenges and future prospects | Signal Transduction and Targeted Therapy. https://www.nature.com/articles/s41392-024-02021-w.
2. Zhang, C., Guan, Y., Sun, Y., Ai, D. & Guo, Q. Tumor heterogeneity and circulating tumor cells. Cancer Lett. 374, 216–223 (2016).
3. Yu, W. et al. Exosome-based liquid biopsies in cancer: opportunities and challenges. Ann. Oncol. Off. J. Eur. Soc. Med. Oncol. 32, 466–477 (2021).
4. Alix-Panabières, C. & Pantel, K. Liquid Biopsy: From Discovery to Clinical Application. Cancer Discov. 11, 858–873 (2021).
5. Wishart, G., Templeman, A., Hendry, F., Miller, K. & Pailhes-Jimenez, A.-S. Molecular Profiling of Circulating Tumour Cells and Circulating Tumour DNA: Complementary Insights from a Single Blood Sample Utilising the Parsortix® System. Curr. Issues Mol. Biol. 46, 773 (2024).
6. Ntzifa, A., Kotsakis, A., Georgoulias, V. & Lianidou, E. Detection of EGFR Mutations in Plasma cfDNA and Paired CTCs of NSCLC Patients before and after Osimertinib Therapy Using Crystal Digital PCR. Cancers 13, 2736 (2021).
7. Gupta, S. et al. Whole Genomic Copy Number Alterations in Circulating Tumor Cells from Men with Abiraterone or Enzalutamide-Resistant Metastatic Castration-Resistant Prostate Cancer. Clin. Cancer Res. Off. J. Am. Assoc. Cancer Res. 23, 1346–1357 (2017).