Introduction: Circulating biomarkers: where have we got to and what’s on the horizon?


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Caroline Dive1
1Cancer Research UK, Manchester, UK

Abstract

Development of novel minimally invasive biomarkers to facilitate precision medicine delivery edges ever closer to routine application. We have witnessed substantial strides forward in recent years with the detection and analysis of circulating tumour DNA (ctDNA) to monitor patients receiving targeted therapies. Assay sensitivity is continually improving, offering a horizon of ctDNA for earlier detection of disease. Challenges remaining are largely related to standardisation blood processing and ctDNA inclusive trial protocols for multi-centre trial samples. Alain Thierry will discuss ctDNA analysis and his application of ctDNA assays for clinical decision making. What then is the added utility of circulating tumour cells (CTCs)? The major technical hurdle for CTC research is the challenge of CTC heterogeneity and urgent need for robust marker independent technology. These challenges are being met and CTC analysis has much to offer regarding the biology of tumour dissemination, tumour heterogeneity and evolution. Christoph Klein will discuss single CTC analysis with diagnostic precision and the implications for the understanding of cancer evolution and therapy selection. Finally, Caroline Dive will describe the emerging field of CTC explant models that can be used to further characterise tumour biology and to test novel therapies in the setting of small cell lung cancer (SCLC) where CTCs are particularly prevalent.