Circulating biomarkers in patients with glioblastoma

Br J Cancer. 2020 Feb;122(3):295-305. doi: 10.1038/s41416-019-0603-6. Epub 2019 Oct 31.

Abstract

Gliomas are the most common tumours of the central nervous system and the most aggressive form is glioblastoma (GBM). Despite advances in treatment, patient survival remains low. GBM diagnosis typically relies on imaging techniques and postoperative pathological diagnosis; however, both procedures have their inherent limitations. Imaging modalities cannot differentiate tumour progression from treatment-related changes that mimic progression, known as pseudoprogression, which might lead to misinterpretation of therapy response and delay clinical interventions. In addition to imaging limitations, tissue biopsies are invasive and most of the time cannot be performed over the course of treatment to evaluate 'real-time' tumour dynamics. In an attempt to address these limitations, liquid biopsies have been proposed in the field. Blood sampling is a minimally invasive procedure for a patient to endure and could provide tumoural information to guide therapy. Tumours shed tumoural content, such as circulating tumour cells, cell-free nucleic acids, proteins and extracellular vesicles, into the circulation, and these biomarkers are reported to cross the blood-brain barrier. The use of liquid biopsies is emerging in the field of GBM. In this review, we aim to summarise the current literature on circulating biomarkers, namely circulating tumour cells, circulating tumour DNA and extracellular vesicles as potential non-invasively sampled biomarkers to manage the treatment of patients with GBM.

Publication types

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

MeSH terms

  • Biomarkers, Tumor / metabolism
  • Blood-Brain Barrier / metabolism
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / metabolism*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy
  • Cell-Free Nucleic Acids / metabolism
  • Circulating Tumor DNA / metabolism*
  • Disease Progression
  • Extracellular Vesicles / metabolism*
  • Glioblastoma / diagnostic imaging
  • Glioblastoma / metabolism*
  • Glioblastoma / pathology
  • Glioblastoma / therapy
  • Humans
  • Liquid Biopsy
  • Neoplasm Metastasis
  • Neoplasm Proteins / metabolism
  • Neoplastic Cells, Circulating / metabolism*
  • RNA, Neoplasm / metabolism
  • Treatment Outcome

Substances

  • Biomarkers, Tumor
  • Cell-Free Nucleic Acids
  • Circulating Tumor DNA
  • Neoplasm Proteins
  • RNA, Neoplasm