Liquid Biopsy in Glioblastoma Management: From Current Research to Future Perspectives
Liquid Biopsy in Glioblastoma Management: From Current Research to Future Perspectives
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DOI：
10.1002/onco.13858
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发表时间：
2021-06-23
期刊：
影响因子：
5.8
通讯作者：
Brandes, Alba Ariela
中科院分区：
文献类型：
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作者：
Gatto, Lidia;Franceschi, Enrico;Brandes, Alba Ariela
胶质母细胞瘤（GBM）是中枢神经系统最常见的原发性肿瘤。 GBM 源自神经上皮胶质细胞，其特点是侵袭行为、广泛的血管生成和遗传异质性，导致预后不良和治疗失败。目前，有多种分子生物标志物可用于帮助诊断、预后和预测治疗结果；然而，所有这些都需要对肿瘤组织进行活检。然而，来自单个位置的组织样本有其自身的局限性，包括与手术相关的风险以及获取纵向样本以监测治疗反应和充分捕获 GBM 的瘤内异质性的难度。迄今为止，血液或脑脊液中尚无用于 GBM 检测、随访或预测的生物标志物。液体活检提供了一种有吸引力的微创解决方案，支持 GBM 管理的不同阶段，评估肿瘤的分子生物学，识别早期复发和纵向基因组进化，预测预后和对化疗或放疗的潜在耐药性，并允许患者选择靶向治疗。本综述的目的是描述有关液体活检在胶质母细胞瘤中应用的当前知识，强调转化为临床护理的好处和障碍。对实践的影响 为了将液体活检转化为临床实践，需要对更大的队列进行进一步的前瞻性研究，以提高特异性和敏感性。随着人们对 RNA 纳米技术的兴趣日益浓厚，microRNA 可能对脑肿瘤具有治疗作用。
Glioblastoma (GBM) is the most common primary tumor of the central nervous system. Arising from neuroepithelial glial cells, GBM is characterized by invasive behavior, extensive angiogenesis, and genetic heterogeneity that contributes to poor prognosis and treatment failure. Currently, there are several molecular biomarkers available to aid in diagnosis, prognosis, and predicting treatment outcomes; however, all require the biopsy of tumor tissue. Nevertheless, a tissue sample from a single location has its own limitations, including the risk related to the procedure and the difficulty of obtaining longitudinal samples to monitor treatment response and to fully capture the intratumoral heterogeneity of GBM. To date, there are no biomarkers in blood or cerebrospinal fluid for detection, follow-up, or prognostication of GBM. Liquid biopsy offers an attractive and minimally invasive solution to support different stages of GBM management, assess the molecular biology of the tumor, identify early recurrence and longitudinal genomic evolution, predict both prognosis and potential resistance to chemotherapy or radiotherapy, and allow patient selection for targeted therapies. The aim of this review is to describe the current knowledge regarding the application of liquid biopsy in glioblastoma, highlighting both benefits and obstacles to translation into clinical care. Implications for Practice To translate liquid biopsy into clinical practice, further prospective studies are required with larger cohorts to increase specificity and sensitivity. With the ever-growing interest in RNA nanotechnology, microRNAs may have a therapeutic role in brain tumors.