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Introduction: Liquid biopsy is defined as the collection of cell-free DNA (cfDNA) and cell-free RNA (cfRNA) in the blood of cancer patients and the use of those components for disease detection and monitoring. cfDNA and cfRNA are released from different cellular compartments, meaning that their profiles may differ with respect to origin and can include different information. cfDNA is released into the bloodstream in a more complex manner than cfRNA. Therefore, the combination of ctDNA and cfRNA can provide a unique profile of the tumour and can be used to monitor changes in the tumour after treatment.AbstractCirculating tumour DNA (ctDNA) has potential applications in gastric cancer (GC) with respect to screening, the detection of minimal residual disease (MRD) following curative surgery, and in the advanced disease setting for treatment decision making and therapeutic monitoring. It can provide a less invasive and convenient method to capture the tumoural genomic landscape compared to tissue-based next-generation DNA sequencing (NGS). In addition, ctDNA can potentially overcome the challenges of tumour heterogeneity seen with tissue-based NGS. The use of ctDNA in cancer, particularly, is rapidly increasing and has been the subject of several recent reviews. This article will review the current and future applications of ctDNA in GC.Keywords: ctDNA; liquid biopsy; gastric cancer
Methods: We did an extensive literature search for articles concerning ctDNA in GC. We only included articles in English and published between 2010 and 2015. We used the databases Medline, Embase and the Cochrane Library to perform the search. Review articles, letters to the editor, and studies in paediatric cancer were excluded. Abstracts were included that dealt with ctDNA in GC and that contained original data. Data on the detection of ctDNA in GC, its use in the screening and follow-up of GC, and MRD were extracted, and the studies were critically analysed for validity and bias. The following data were extracted: authorship, date of publication, study design, ctDNA types (cell-free DNA (cfDNA), cell-free RNA (cfRNA) or both), relevant clinical information, and ctDNA methods.
Tumour-derived cell-free DNA, also known as circulating tumour DNA (ctDNA): DNA is released into the blood stream by dying cancer cells. In patients with cancer, ctDNA is an important marker of disease progression and prognosis. As a biomarker, ctDNA is useful for cancer screening, the detection of minimal residual disease (MRD) following curative surgery, and in the advanced disease setting for treatment decision making and therapeutic monitoring. It can provide a less invasive and convenient method to capture the tumoural genomic landscape compared to tissue-based next-generation DNA sequencing (NGS). In addition, ctDNA can potentially overcome the challenges of tumour heterogeneity seen with tissue-based NGS. Although the evidence for ctDNA in GC is evolving, its potential utility is far reaching and may shape the management of this disease in the future. This article will review the current and future applications of ctDNA in GC.Keywords: ctDNA; liquid biopsy; gastric cancer 827ec27edc