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Dynamic sequencing of circulating tumor DNA: novel noninvasive cancer biomarker.

Despite high-throughput technological and computational advances, progress in discovering robust biomarkers for personalized monitoring of cancer patients with potentially curable or metastatic disease is modest. Genome sequencing of ‘fluid’ biopsy may be a novel robust biomarker in monitoring cancer patients after treatment. In this article, we highlight the proof of principle for circulating tumor DNA (ctDNA) sequencing provided by a recent study [1] and the challenges for clinical implementation. If confirmed, this new method will change clinical trials’ design. The combination of this new technique for ctDNA detection in plasma and the subsequent next-generation sequencing (NGS) can provide a dual advantage. First, it can early predict recurrence or disease progression before this event occurs. Second, this ctDNA-NGS-based approach can guide a new therapeutic decision selecting drug(s) to disrupt cellular pathways deregulated by initial therapy-resistant emerging mutations and clonal selection rather than primary tumor genetic analysis.