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Review of the clinical applications and technological advances of circulating tumor DNA in cancer monitoring

Authors Chang Y, Tolani B, Nie XH, Zhi XY, Hu M, He B

Received 19 May 2017

Accepted for publication 15 July 2017

Published 11 October 2017 Volume 2017:13 Pages 1363—1374


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Garry Walsh

Yi Chang,1,2,* Bhairavi Tolani,2,* Xiuhong Nie,1 Xiuyi Zhi,3 Mu Hu,3 Biao He2

1Department of Respiratory Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; 2Thoracic Oncology Program, Department of Surgery, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA; 3Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China

*These authors contributed equally to this work

Circulating cell-free DNA (cfDNA) released by tumor cells, termed ctDNA, closely reflects the heterogeneity of primary cancers and their metastases. As a noninvasive, real-time monitoring biomarker, ctDNA is a promising tool for detecting driver gene mutations, assessing tumor burden and acquired resistance, and early diagnosis. However, isolation and enrichment of cfDNA is a big challenge due to the high degree of DNA fragmentation and its relatively low abundance in the bloodstream. This review aims to provide insights into the recent technological advances in acquisition of optimal quality cfDNA, the use of preservatives, isolation methods, processing timelines, and detection techniques. It also describes clinical applications of ctDNA in cancer patient management.

Keywords: circulating tumor DNA, ctDNA, liquid biopsy, cancer monitoring, tumor heterogeneity, targeted therapies, biomarkers

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