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Liquid biopsy in the clinical management of hepatocellular carcinoma
  1. Johann von Felden1,
  2. Teresa Garcia-Lezana2,
  3. Kornelius Schulze1,
  4. Bojan Losic3,
  5. Augusto Villanueva2,4
  1. 1Department of Internal Medicine, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
  2. 2Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, New York, USA
  3. 3Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  4. 4Division of Hematology and Medical Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  1. Correspondence to Dr Johann von Felden, Department of Internal Medicine, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany; j.von-felden{at}uke.de; Dr Augusto Villanueva, Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, New York, United States; augusto.villanueva{at}mssm.edu

Abstract

With increasing knowledge on molecular tumour information, precision oncology has revolutionised the medical field over the past years. Liquid biopsy entails the analysis of circulating tumour components, such as circulating tumour DNA, tumour cells or tumour-derived extracellular vesicles, and has thus come as a handy tool for personalised medicine in many cancer entities. Clinical applications under investigation include early cancer detection, prediction of treatment response and molecular monitoring of the disease, for example, to comprehend resistance patterns and clonal tumour evolution. In fact, several tests for blood-based mutation profiling are already commercially available and have entered the clinical field.

In the context of hepatocellular carcinoma, where access to tissue specimens remains mostly limited to patients with early stage tumours, liquid biopsy approaches might be particularly helpful. A variety of translational liquid biopsy studies have been carried out to address clinical needs, such as early hepatocellular carcinoma detection and prediction of treatment response. To this regard, methylation profiling of circulating tumour DNA has evolved as a promising surveillance tool for early hepatocellular carcinoma detection in populations at risk, which might soon transform the way surveillance programmes are implemented. This review summarises recent developments in the liquid biopsy oncological space and, in more detail, the potential implications in the clinical management of hepatocellular carcinoma. It further outlines technical peculiarities across liquid biopsy technologies, which might be helpful for interpretation by non-experts.

  • hepatobiliary cancer
  • surveillance
  • tumour markers
  • hepatocellular carcinoma
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Footnotes

  • Twitter @JohannvonFelden, @teresaglezana, @augustoNYC

  • JvF and AV contributed equally.

  • Contributors JvF and AV outlined the manuscript. JvF, TG-L, KS, BL and AV performed review of the literature and writing of the article. All authors approved the final version of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AV has received consulting fees from Guidepoint and Fujifilm; advisory board fees from Exact Sciences, Nucleix and NGM Pharmaceuticals and research support from Eisai Pharmaceuticals. The remaining authors have nothing to declare in respect to this manuscript.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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