Friday, May 20, 2016

Liquid Biopsy in Lung Cancer: A Perspective From Members of the Pulmonary Pathology Society

Lynette M. Sholl MDDara L. Aisner MD, PhDTimothy Craig Allen MD, JDMary Beth Beasley MDPhilip T. Cagle MD;Vera L. Capelozzi MD, PhDSanja Dacic MD, PhDLida P. Hariri MD, PhDKeith M. Kerr MD, BSc, MB, ChB, FRCPath, FRCPESylvie Lantuejoul MD, PhDMari Mino-Kenudson MDKirtee Raparia MBBSNatasha Rekhtman MD, PhDSinchita Roy-Chowdhuri MD, PhDEric Thunnissen MD, PhDMing Tsao MDMarina Vivero MDYasushi Yatabe MD, PhD
Reprints: Timothy Craig Allen, MD, JD, Department of Pathology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555 (email: ).
Liquid biopsy has received extensive media coverage and has been called the holy grail of cancer detection. Attempts at circulating tumor cell and genetic material capture have been progressing for several years, and recent financially and technically feasible improvements of cell capture devices, plasma isolation techniques, and highly sensitive polymerase chain reaction– and sequencing-based methods have advanced the possibility of liquid biopsy of solid tumors. Although practical use of circulating RNA-based testing has been hindered by the need to fractionate blood to enrich for RNAs, the detection of circulating tumor cells has profited from advances in cell capture technology. In fact, the US Food and Drug Administration has approved one circulating tumor cell selection platform, the CellSearch System. Although the use of liquid biopsy in a patient population with a genomically defined solid tumor may potentially be clinically useful, it currently does not supersede conventional pretreatment tissue diagnosis of lung cancer. Liquid biopsy has not been validated for lung cancer diagnosis, and its lower sensitivity could lead to significant diagnostic delay if liquid biopsy were to be used in lieu of tissue biopsy. Ultimately, notwithstanding the enthusiasm encompassing liquid biopsy, its clinical utility remains unproven.

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