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Current role of liquid biopsy in metastatic breast cancer and future perspectives

„Liquid biopsy“ beim metastasierten Mammakarzinom – aktuelle Relevanz und Zukunftsperspektiven

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Der Gynäkologe Aims and scope

An Erratum to this article was published on 26 September 2016

Abstract

The possibility of tumor dissemination via the blood system has been known for many years. Circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) are detectable in the peripheral blood of patients with early as well as metastatic breast cancer. The prognostic relevance of these biomarkers has already been described. Repeated blood sampling along the course of disease enables CTCs and ctDNA to be monitored in terms of a regular “liquid biopsy”. Combined with an additional molecular analysis, this might be helpful in gaining information about tumor characteristics, tumor heterogeneity, and possible therapy resistance based on these factors, without the necessity of an invasive core biopsy. The assessment of molecular attributes may be indispensable for obtaining an optimized and personalized therapy aimed at extended survival and/or improved quality of life. This review summarizes current knowledge and describes possible future perspectives for the treatment of metastasized breast cancer.

Zusammenfassung

Die Möglichkeit einer Streuung von Tumorzellen über das Blutsystem ist seit vielen Jahren bekannt. Zirkulierende Tumorzellen (CTCs) und zirkulierende Tumor-DNA (ctDNA) können bei Patientinnen sowohl mit frühem als auch mit metastasiertem Mammakarzinom nachgewiesen werden. Ihre prognostische Relevanz wurde ebenfalls bereits beschrieben. Durch wiederholte Blutentnahmen im Verlauf der Erkrankung ist es möglich, CTCs und ctDNA im Sinne einer regelmäßigen „liquid biopsy“ zu kontrollieren. In Kombination mit einer zusätzlichen molekularen Charakterisierung der CTCs könnte dies helfen, Tumorcharakteristika, Tumorheterogenität und darauf basierende mögliche Resistenzen ohne histopathologische Gewebeuntersuchung zu erkennen. Dadurch sollen zielgerichtete, personalisierte Therapien entwickelt werden, um ein verlängertes progressionsfreies Überleben und/oder eine verbesserte Lebensqualität zu erreichen. Dieser Übersichtsartikel fasst aktuelle Forschungsergebnisse zusammen und stellt mögliche Zukunftsperspektiven für die Therapie des metastasierten Mammakarzinoms dar.

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Authors and Affiliations

  1. Gynecology and Obstetrics, University Hospital Ulm, Prittwitzstr. 43, 89075, Ulm, Germany

    Arkadius Polasik, Thomas W. P. Friedl, Amelie Schramm, Fabienne Schochter, Jens Huober & Wolfgang Janni

  2. Gynecology and Obstetrics, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany

    Brigitte Rack, Elisabeth Trapp & Marie Tzschaschel

  3. Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany

    Peter A. Fasching

  4. Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany

    Florin-Andrei Taran & Andreas Hartkopf

  5. National Center for Tumor Diseases and Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Germany

    Andreas Schneeweiss

  6. Gynecology and Obstetrics, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Volkmar Müller

  7. Gynecology and Obstetrics, University Hospital Essen, Essen, Germany

    Bahriye Aktas

  8. Department of Tumor Biology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Klaus Pantel

  9. Gynecology and Obstetrics, Heinrich-Heine-Universität, Düsseldorf, Germany

    Tanja Fehm

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  1. Arkadius Polasik
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Correspondence to Arkadius Polasik.

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Conflict of interest

A. Polasik, T.W.P. Friedl, A. Schramm, F. Schochter, J. Huober, B. Rack, E. Trapp, M. Tzschaschel, P.A. Fasching, F.-A. Taran, A. Hartkopf, A. Schneeweiss, V. Müller, B. Aktas, K. Pantel, W. Janni, and T. Fehm declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00129-016-3970-6.

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Polasik, A., Friedl, T.W.P., Schramm, A. et al. Current role of liquid biopsy in metastatic breast cancer and future perspectives. Gynäkologe 49, 680–684 (2016). https://doi.org/10.1007/s00129-016-3929-7

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