Changing the paradigm: circulating tumor DNA as a liquid biopsy for clinical biomarker assessments

Author(s): Timothy R Wilson & Mark R Lackner

Clinical development of targeted anticancer therapies often involves interrogation of key driver alterations through diagnostic assessment of tumor DNA. However, predictive biomarker assessment of tumor tissue has substantial limitations. Recent clinical studies of circulating tumor DNA suggest such DNA may be a paradigmchanging medium for the diagnosis and management of cancer patients that can provide an up-to-date ‘liquid biopsy’ for use in clinical diagnostic assessment. The field is evolving rapidly and numerous studies have shown that highly sensitive technologies allow for detection of genomic alterations in circulating tumor DNA. Here, we consider how these advances have the potential to shape pharmacodynamic and predictive biomarker assessments in clinical trials by providing comprehensive, real-time molecular assessment in a minimally invasive manner.