title: The translational potential of circulating tumour DNA in oncology.
abstract: The recent understanding of tumour heterogeneity and cancer evolution in response to therapy has raised questions about the value of historical or single site biopsies for guiding treatment decisions. The ability of ctDNA analysis to reveal de novo mutations (i.e., without prior knowledge), allows monitoring of clonal heterogeneity without the need for multiple tumour biopsies. Additionally, ctDNA monitoring of such heterogeneity and novel mutation detection will allow clinicians to detect resistant mechanisms early and tailor treatment therapies accordingly. If ctDNA can be used to detect low volume cancerous states, it will have important applications in treatment stratification post-surgery/radical radiotherapy and may have a role in patient screening. Mutant cfDNA can also be detected in other bodily fluids that are easily accessible and may aid detection of rare mutant alleles in certain cancer types. This article outlines recent advances in these areas.
authors.affiliation: Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK; Department of Academic Urology, University of Cambridge Hospitals, Box 243, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
authors.forename: K M
authors.initials: KM
authors.lastname: Patel
authors.affiliation: Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK. Electronic address: dana.tsui@cruk.cam.ac.uk.
authors.forename: D W Y
authors.initials: DW
authors.lastname: Tsui
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis / Q000097:blood / Q000737:chemistry / Q000652:urine; D004273:DNA, Neoplasm / Q000032:analysis / Q000097:blood* / Q000737:chemistry / Q000652:urine; D019008:Drug Resistance, Neoplasm; D055088:Early Detection of Cancer / Q000009:adverse effects / Q000639:trends; D005820:Genetic Testing / Q000639:trends; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008495:Medical Oncology / Q000379:methods* / Q000639:trends; D025202:Molecular Diagnostic Techniques / Q000639:trends; D009154:Mutation; D009369:Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism; D057285:Precision Medicine / Q000639:trends; D017422:Sequence Analysis, DNA / Q000639:trends; D057170:Translational Research, Biomedical / Q000639:trends
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D004273:DNA, Neoplasm
keywords: Blood; Cancer; Circulating nucleic acids; DNA; Next generation sequencing; Oncology; Plasma; Urine