Circulating tumor DNA detection in hepatocellular carcinoma

Circulating tumor DNA (ctDNA) analysis has demonstrated excellent specificity and satisfactory sensitivity to detect somatic mutations across many tumor types and particularly in patients with metastatic disease [1,2]. ctDNA detection rate and level primarily depend on tumor burden, proliferation and tumor type [3]. Its clinical use as a theragnostic biomarker for detectingEGFR mutation has been approved in stage IV non-small-cell lung cancer patients, in whom invasive tumor biopsy may be perilous because of limited accessibility and/or pre-existing organ dysfunction (e.g. emphysema). In that regard, biopsies of hepatocellular carcinoma (HCC) face the same challenges, with poor accessibility of some liver lesions and pre-existing cirrhosis and/or coagulopathy due to liver failure. In turn, HCC belongs to the few tumor types in which diagnosis can be established without an invasive biopsy, using combined radiological and biological (alpha-fetoprotein) criteria. Patients diagnosed with HCC have two main therapeutic options: locoregional treatments (i.e. surgery, embolization, radiofrequency or transplantation), prioritized in patients with non-metastatic HCC amenable to such treatments, and systemic treatments (e.g. sorafenib and regorafenib, two inhibitors of protein kinases with antiproliferative and antiangiogenic properties) proposed to patients with metastatic disease and/or unfit for locoregional treatments. Recent sequencing studies revealed potential therapeutic targets...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research