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However, the authors acknowledge that ctDNA analysis is not without limitations; plasma samples collected post-operatively were only able to predict recurrence at 36 months in 48% of cases. [27] Subsequently, ctDNA assays have been developed for both colorectal cancer [43] and melanoma. [44]
The technique becomes questionable when ctDNA is present at low levels of 0.01%. Also, when there is less discharge of ctDNA due to stability of tumor growth by therapy, the detection is compromised. [12] [13] Whether ctDNA is released at equal or unequal rate from primary tumors and metastatic diseases is still unknown. This fact should be ...
An alternative DNA source is circulating tumor DNA (ctDNA). ctDNA primarily originates from apoptotic and necrotic tumor cells that release their fragmented DNA into the circulation. [4] It is believed that the amount of ctDNA in plasma is correlated with tumor progression and thus it has the potential to be utilized as a cancer prognostic marker.
An illustration depicting primary tumor (in the form of tumor microenvironment) and the circulating tumor cells. A circulating tumor cell (CTC) is a cancer cell from a primary tumor that has shed into the blood of the circulatory system, or the lymph of the lymphatic system. [1]
[21] [22] The ability to extract circulating tumor DNA (ctDNA) from the human plasma has led to huge advancements in noninvasive cancer detection. [23] Most notably, it has led to what is now known as liquid biopsy. In short, liquid biopsy is using biomarkers and cancer cells in the blood as a means of diagnosing cancer type and stage. [24]
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