Background: There is an extensive literature highlighting the utility of blood-based liquid biopsies in several extracranial tumors for diagnosis and monitoring. Methods: The RANO (Response Assessment in Neuro-Oncology) group developed a multidisciplinary international Task Force to review the English literature on liquid biopsy in gliomas focusing on the most frequently used techniques, i.e. circulating tumor DNA, circulating tumor cells and extracellular vesicles in blood and CSF. Results: ctDNA has a higher sensitivity and capacity to represent the spatial and temporal heterogeneity in comparison to circulating tumor cells. Exosomes have the advantages to cross an intact blood-brain barrier and carry also RNA, miRNA and proteins. Several clinical applications of liquid biopsies are suggested: to establish a diagnosis when tissue is not available, monitor the residual disease after surgery, distinguish progression from pseudoprogression, and predict outcome. Conclusions: There is need for standardization of biofluid collection, choice of analyte, and detection strategies along with rigorous testing in future clinical trials to validate findings and enable entry into clinical practice.
Liquid biopsy in gliomas: a RANO review and proposals for clinical applications
Soffietti, Riccardo
First
;Rudà, Roberta;
2022-01-01
Abstract
Background: There is an extensive literature highlighting the utility of blood-based liquid biopsies in several extracranial tumors for diagnosis and monitoring. Methods: The RANO (Response Assessment in Neuro-Oncology) group developed a multidisciplinary international Task Force to review the English literature on liquid biopsy in gliomas focusing on the most frequently used techniques, i.e. circulating tumor DNA, circulating tumor cells and extracellular vesicles in blood and CSF. Results: ctDNA has a higher sensitivity and capacity to represent the spatial and temporal heterogeneity in comparison to circulating tumor cells. Exosomes have the advantages to cross an intact blood-brain barrier and carry also RNA, miRNA and proteins. Several clinical applications of liquid biopsies are suggested: to establish a diagnosis when tissue is not available, monitor the residual disease after surgery, distinguish progression from pseudoprogression, and predict outcome. Conclusions: There is need for standardization of biofluid collection, choice of analyte, and detection strategies along with rigorous testing in future clinical trials to validate findings and enable entry into clinical practice.
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