Clinical Applications of Circulating Tumour Cells and Circulating Tumour DNA in Non-Small Cell Lung Cancer-An Update

Joanna Kapeleris; Majid Ebrahimi Warkiani; Arutha Kulasinghe; Ian Vela; Liz Kenny; Rahul Ladwa; Kenneth O'Byrne; Chamindie Punyadeera

doi:10.3389/fonc.2022.859152

Clinical Applications of Circulating Tumour Cells and Circulating Tumour DNA in Non-Small Cell Lung Cancer-An Update

Front Oncol. 2022 Mar 15:12:859152. doi: 10.3389/fonc.2022.859152. eCollection 2022.

Authors

Joanna Kapeleris^{1

2}, Majid Ebrahimi Warkiani³, Arutha Kulasinghe^{2

4}, Ian Vela^{4

5

6}, Liz Kenny⁷, Rahul Ladwa^{8

9}, Kenneth O'Byrne^{2

8}, Chamindie Punyadeera^{1

2

10}

Affiliations

¹ Saliva and Liquid Biopsy Translational Laboratory, The Centre for Biomedical Technologies, The School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia.
² Translational Research Institute, Brisbane, QLD, Australia.
³ School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, Australia.
⁴ The School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
⁵ Australian Prostate Cancer Research Centre, Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Princess Alexandra Hospital, Translational Research Institute, Brisbane, QLD, Australia.
⁶ Department of Urology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
⁷ School of Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Central Integrated Regional Cancer Service, Queensland Health, Brisbane, QLD, Australia.
⁸ Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
⁹ School of Medicine, University of Queensland, Herston, QLD, Australia.
¹⁰ Saliva and Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery and Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia.

Abstract

Despite efforts to improve earlier diagnosis of non-small cell lung cancer (NSCLC), most patients present with advanced stage disease, which is often associated with poor survival outcomes with only 15% surviving for 5 years from their diagnosis. Tumour tissue biopsy is the current mainstream for cancer diagnosis and prognosis in many parts of the world. However, due to tumour heterogeneity and accessibility issues, liquid biopsy is emerging as a game changer for both cancer diagnosis and prognosis. Liquid biopsy is the analysis of tumour-derived biomarkers in body fluids, which has remarkable advantages over the use of traditional tumour biopsy. Circulating tumour cells (CTCs) and circulating tumour DNA (ctDNA) are two main derivatives of liquid biopsy. CTC enumeration and molecular analysis enable monitoring of cancer progression, recurrence, and treatment response earlier than traditional biopsy through a minimally invasive liquid biopsy approach. CTC-derived ex-vivo cultures are essential to understanding CTC biology and their role in metastasis, provide a means for personalized drug testing, and guide treatment selection. Just like CTCs, ctDNA provides opportunity for screening, monitoring, treatment evaluation, and disease surveillance. We present an updated review highlighting the prognostic and therapeutic significance of CTCs and ctDNA in NSCLC.

Keywords: NSCLC; circulating tumour DNA (ctDNA); circulating tumour cell (CTC); liquid biopsy; lung cancer.

Publication types

Review