Current Perspectives on Circulating Tumor DNA, Precision Medicine, and Personalized Clinical Management of Cancer

Mol Cancer Res. 2020 Apr;18(4):517-528. doi: 10.1158/1541-7786.MCR-19-0768. Epub 2020 Jan 29.

Abstract

Circulating tumor DNA (ctDNA) has recently emerged as a minimally invasive "liquid biopsy" tool in precision medicine. ctDNA-genomic DNA fragments that are released into the bloodstream after the active secretion of microvesicles or tumor cell lysis reflects tumor evolution and the genomic alterations present in primary and/or metastatic tumors. Notably, ctDNA analysis might allow the stratification of patients, the monitoring of the therapeutic response, and the establishment of an opportunity for early intervention independent of detection by imaging modalities or clinical symptoms. As oncology moves towards precision medicine, the information in ctDNA provides a means for the individual management of the patient based on their tumor's genetic profile. This review presents current evidence on the potential role for ctDNA in helping to guide individualized clinical treatment decisions for patients with melanoma, castration-resistant prostate cancer, breast cancer, metastatic colorectal cancer, and non-small cell lung cancer.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Circulating Tumor DNA / genetics*
  • Humans
  • Neoplasms / therapy*
  • Precision Medicine / methods*

Substances

  • Circulating Tumor DNA