The Diversity of Circulating Tumor Markers: a Trend Towards a Multimodal Liquid Biopsy

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Abstract

Over the past decade, liquid biopsy (LB) has become a routine diagnostic test essential for the treatment of malignant tumors of various localizations. Its capabilities include early diagnosis, molecular genotyping, prognosis, prediction, and monitoring of tumor response. Typically, liquid biopsy involves the extraction of a single type of tumor-derived molecules or cellular elements from blood and subsequent molecular analysis. These elements may include circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), circulating RNA (ctRNA), or the contents of extracellular vesicles (exosomes). Despite the technical sophistication of molecular analysis methods for circulating biomarkers, this diagnostic approach has limited relevance. In a significant proportion of cancer patients (ranging from 10 to 50%, depending on the tumor type), none of these analytes can be detected and analyzed, despite the presence of large, progressing neoplastic foci in the body. It seems reasonable to posit that heterogeneous fractions of circulating tumor-specific biomarkers complement each other, thus, the simultaneous analysis of several fractions will not only increase the sensitivity of the method but also more accurately characterize and predict the clinical situation. This review examines the possibilities and advantages of applying a combined multiparametric approach to liquid biopsy, which involves testing multiple circulating analytes in a single blood sample.

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About the authors

E. Sh. Kuligina

Petrov National Medical Research Center of Oncology

Author for correspondence.
Email: kate.kuligina@gmail.com
Russian Federation, 197758, Saint Petersburg

G. A. Yanus

Petrov National Medical Research Center of Oncology; Saint Petersburg State Pediatric Medical University

Email: kate.kuligina@gmail.com
Russian Federation, 197758, Saint Petersburg; 194100, Saint Petersburg

E. N. Imyanitov

Petrov National Medical Research Center of Oncology; Saint Petersburg State Pediatric Medical University

Email: kate.kuligina@gmail.com
Russian Federation, 197758, Saint Petersburg; 194100, Saint Petersburg

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2. Fig. 1. Circulating molecules and cellular elements of tumour origin circulating in peripheral blood used for WDs

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