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Liquid Biopsy in der Tumordiagnostik

Anwendungen, Perspektiven und Limitationen des Cancer Liquidome

Liquid biopsy in tumor diagnostics

Applications, perspectives, and limitations of the “cancer liquidome”

  • Pathologie
  • Published:
Wiener klinisches Magazin Aims and scope

Zusammenfassung

Der Nachweis genetischer Veränderungen in Körperflüssigkeiten als Ergänzung oder gar Ersatz der konventionellen gewebebasierten Tumordiagnostik ist ein aktuell in Forschung und Industrie viel beachtetes und diskutiertes Thema. Technische Fortschritte in der Nukleinsäureanalytik im Verbund mit vielversprechenden Studienergebnissen haben sehr große Erwartungen geweckt bezüglich Früherkennung, Diagnostik, Prognostik und Monitoring von Tumorerkrankungen mithilfe einer minimalinvasiven Blutprobe. Einzelne fokussierte Assays haben bereits Eingang in die Routinediagnostik gefunden und stellen eine sinnvolle Ergänzung zur etablierten Tumordiagnostik dar, wenn eine Gewebeprobe nicht gewonnen werden kann. Vor einer Ausweitung des Einsatzes von Liquid Biopsy außerhalb von Studien und des Nachweises komplexer Marker im peripheren Blut (wie z. B. der Tumormutationslast) sind aber zahlreiche methodische Herausforderungen und konzeptionelle Probleme zu lösen. Der vorliegende Artikel konzentriert sich auf den Nachweis freier zirkulierender Tumor-DNA im Blutplasma und diskutiert kritisch Anwendungsfelder und Potenziale sowie Herausforderungen und Grenzen dieser Methodik.

Abstract

The detection of tumor-specific genetic alterations in body fluids as an addition to or even replacement for established tissue-based tumor diagnostics is currently a hot topic in academic research and industry. Progress in methods for nucleic acid analyses together with promising results from clinical studies have raised great expectations for cancer screening, diagnosis, prognosis, and therapy monitoring by means of a minimally invasive blood draw. Individual focused assays have already been introduced into routine diagnostics and represent a valuable option in cases where no tissue samples are available. However, before the use of liquid biopsy outside of clinical studies is enforced and more complex markers (like tumor mutational burden) are analyzed, several practical challenges and principal problems have to be addressed. This review focusses on the detection of free-circulating nucleic acids in blood plasma and critically discusses established and future applications as well as challenges and limitations of this new method.

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Authors and Affiliations

  1. Institut für Pathologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    Ulrich Lehmann &  Stephan Bartels

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  1. Ulrich Lehmann
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  2. Stephan Bartels
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Correspondence to Ulrich Lehmann.

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Interessenkonflikt

U. Lehmann und S. Bartels geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Dieser Beitrag wurde in der Zeitschrift Der Pathologe 3/2019 · 40:250–255, https://doi.org/10.1007/s00292-019-0604-5 erstveröffentlicht. Zweitpublikation mit freundlicher Genehmigung der Autoren.

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Lehmann, U., Bartels, S. Liquid Biopsy in der Tumordiagnostik. Wien klin Mag 23, 38–43 (2020). https://doi.org/10.1007/s00740-019-00314-3

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  • DOI: https://doi.org/10.1007/s00740-019-00314-3

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