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Innovations & Thérapeutiques en Oncologie

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The role of circulating tumour DNA in cancer management: challenges and new perspectives Volume 8, issue 3, May-June 2022

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Authors
1 Institut de cancérologie de Lorraine6, avenue de Bourgogne54519 Vandœuvre-lès-NancyFrance
2 Université de Lorraine, CNRS UMR7039CRANInstitut de cancérologie de LorraineService de biopathologie54519 Vandœuvre-lès-NancyFrance
3 Institut de cancérologie de LorraineService d’oncologie médicale54519 Vandœuvre-lès-NancyFrance
Tirés à part : A. Harlé

Over the past 20 years, identification of the molecular mechanisms involved in carcinogenesis and the development of targeted therapies have revolutionised cancer treatment. The molecular diagnosis of tumours, leading to the identification of molecular changes within the tumour tissue, has become essential for the treatment of cancer patients. This guides diagnosis and allows treatment to be adjusted according to the prognosis, but also helps in the selection of the most appropriate treatment, in particular, by identifying markers that are sensitive or resistant to certain treatments. However, the techniques used to take tumour tissues samples for this analysis are invasive, sometimes difficult to carry out, and generally do not reflect the heterogeneity of the tumour. A liquid biopsy, based on circulating tumour DNA (ctDNA) released into biological fluids by the tumour cells, has been recognised as a promising alternative to conventional tissue biopsies. The improvement in ctDNA enrichment techniques based on biological samples and the use of ultrasensitive analytical techniques have led to the routine use of liquid biopsies for theranostic purposes in bronchial cancers. The use of liquid biopsies in other cancers is currently being assessed in numerous clinical studies. Other applications can now be envisaged in clinical practice, including screening and early diagnosis of cancers, patient follow-up, response to treatment and identifying mechanisms of resistance.