title: The circulating transcriptome as a source of non-invasive cancer biomarkers: concepts and controversies of non-coding and coding RNA in body fluids.
abstract: The gold standard for cancer diagnosis remains the histological examination of affected tissue, obtained either by surgical excision, or radiologically guided biopsy. Such procedures however are expensive, not without risk to the patient, and require consistent evaluation by expert pathologists. Consequently, the search for non-invasive tools for the diagnosis and management of cancer has led to great interest in the field of circulating nucleic acids in plasma and serum. An additional benefit of blood-based testing is the ability to carry out screening and repeat sampling on patients undergoing therapy, or monitoring disease progression allowing for the development of a personalized approach to cancer patient management. Despite having been discovered over 60 years ago, the clear clinical potential of circulating nucleic acids, with the notable exception of prenatal diagnostic testing, has yet to translate into the clinic. The recent discovery of non-coding (nc) RNA (in particular micro(mi)RNAs) in the blood has provided fresh impetuous for the field. In this review, we discuss the potential of the circulating transcriptome (coding and ncRNA), as novel cancer biomarkers, the controversy surrounding their origin and biology, and most importantly the hurdles that remain to be overcome if they are really to become part of future clinical practice.
authors.affiliation: Oncology Area, Biodonostia Research Institute, San Sebastian, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Fernandez-Mercado
authors.affiliation: Oncology Area, Biodonostia Research Institute, San Sebastian, Spain.
authors.forename: Lorea
authors.initials: L
authors.lastname: Manterola
authors.affiliation: Oncology Area, Biodonostia Research Institute, San Sebastian, Spain.
authors.forename: Erika
authors.initials: E
authors.lastname: Larrea
authors.affiliation: Oncology Area, Biodonostia Research Institute, San Sebastian, Spain.
authors.forename: Ibai
authors.initials: I
authors.lastname: Goicoechea
authors.affiliation: Oncology Area, Biodonostia Research Institute, San Sebastian, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Arestin
authors.affiliation: Oncology Area, Biodonostia Research Institute, San Sebastian, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Armesto
authors.affiliation: Multiple Sclerosis Group, Biodonostia Research Institute, San Sebastian, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Otaegui
authors.affiliation: Oncology Area, Biodonostia Research Institute, San Sebastian, Spain.|Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, UK.|IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Lawrie
mesh_terms: D000818:Animals; D014408:Biomarkers, Tumor / Q000097:blood* / Q000235:genetics*; D001826:Body Fluids / Q000378:metabolism*; D005110:Extracellular Space / Q000378:metabolism; D006801:Humans; D012334:RNA, Neoplasm / Q000235:genetics / Q000378:metabolism; D022661:RNA, Untranslated / Q000235:genetics*; D059467:Transcriptome / Q000235:genetics*
chemical_list: D014408:Biomarkers, Tumor; D012334:RNA, Neoplasm; D022661:RNA, Untranslated
keywords: biological fluid; biomarker; microRNA; ncRNA; non-invasive