About this Research Topic
Since the development of the first targeted therapy, oncology care has moved from a one-size-fits-all paradigm towards a tailored treatment, selected on the basis of patient-specific molecular and clinical features . The discipline of Pharmacogenetics (PGx) studies in fact the relationship between specific DNA-sequence variation and the effect of drugs in terms of both efficacy and toxicity.
The implementation of PGx in cancer treatment still needs several issues to be addressed, since it is often difficult to collect enough tissue for genomic tests. However, in the precision medicine era the identification of resistance mechanisms is critical for treatments optimization and a growing research interest is focused towards encouraging alternatives in this context, among which liquid biopsy seems to be the most appealing.
Recently, technological advances, particularly next-generation sequencing (NGS), have paved the way to personalized medicine by reducing time and costs required to assess an individual's and a disease’s genetic make-up. Nowadays, it is unquestionable that NGS technology offers the opportunity to look with extraordinary depth into biological samples, identifying low frequency DNA variants.
One encouraging application of NGS is the so-called liquid biopsy for cancer detection and monitoring towards a personalized cancer-medicine strategy. In the last years, not surprisingly, we witnessed a growing research interest in liquid biopsy. The term liquid biopsy, according to NCI Dictionary of Cancer Terms, illustrates “a test done on a blood sample looking for cancer cells from a tumor that are circulating in the blood or for pieces of DNA from tumor cells that are in the blood”. Liquid biopsies allow detection of different molecules circulating in the blood stream that may play an important role in diagnosing tumors, monitoring their evolution and evaluating treatment response and pharmacological resistance. These include circulating-free DNA (cfDNA), circulating tumor DNA (ctDNA), circulating tumor cells (CTCs) and extracellular vesicles (EVs).
Recent evidence revealed that cfDNA is released during physiological cells’ processes and denotes DNA fragments outside of cells in different body fluids. cfDNA also embraces ctDNA, which is DNA specifically derived from tumors. CTCs are tumor cells released by tumor lesions or metastases. EVs are vesicles secreted from cells within normal and pathological conditions and contain specific molecules including non-codifying RNAs.
Liquid biopsy offers key implications in clinical management, promising to revolutionize the standard management of oncological patients.
This Research Topic aims to highlight how liquid biopsies can offer solutions to clinical applications, providing a novel tool to achieve the goal of precision oncology prescribing the right drug and right treatment to the right patient.
Original Research papers or Reviews describing the latest advances of liquid biopsy are welcome. Subtopics of this Research Topic may include, but are not limited to:
· Liquid biopsy for cancer diagnosis, prognosis therapeutic drug monitoring, and toxicology;
· Liquid biopsy and epigenetics;
· cfDNA and ctDNA as clinical biomarkers;
· Liquid biopsy for stratification and monitoring of cancer patients;
· Liquid biopsy for the detection of actionable oncogenic mutations in cancers;
· Application of sensitive technologies for liquid biopsy.
Keywords: Liquid biopsy, precision medicine, biomarkers, clinical pharmacology, pharmacogenetics, cancer patients
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