Liquid biopsy zur Individualisierung der Therapie beim fortgeschrittenen Harnblasenkarzinom

Zusammenfassung

Die Analyse von Körperflüssigkeiten („Liquid biopsy“), rückt zunehmend in den Fokus der Biomarkerentwicklung, da sie entscheidende Vorteile gegenüber der Gewebeanalyse aufweist. In den Körperflüssigkeiten können neben Proteinen und Lipoproteinen auch zirkulierende Tumorzellen (CTCs), extrazelluläre Vesikel (EVs) sowie deren Bestandteile und zellfreie Nukleinsäuren (DNA, RNA) analysiert werden. Muskelinvasive Harnblasentumore (MIHB) stellen eine besondere klinische Herausforderung dar. Hier werden neue Biomarker benötigt, um das individuelle Metastasierungsrisiko einzuschätzen, die Metastasierung im Follow-up frühzeitig zu erkennen und die effektivste systemische Therapie für den einzelnen Patienten einzusetzen. Diese Arbeit gibt einen Überblick über den aktuellen Stand zur „Liquid Biospy“ aus dem Blut bei fortgeschrittenen MIHB unter Berücksichtigung von CTCs, zirkulierender Tumor-DNA (ctDNA), nicht kodierenden RNAs (ncRNAs) sowie EVs und deren Bedeutung für Prognosebewertung und Therapieentscheidung.

Abstract

Biomarker development is focussing more and more on the analysis of body fluids (“liquid biopsy“) due to its advantages compared to tissue analysis. In addition to proteins and lipoproteins, circulating tumour cells (CTCs), extracellular vesicles (EVs) and cell-free nucleic acids (DNA, RNA) can be investigated from body fluids. Treatment of muscle-invasive balder cancer (MIBC) is still challenging. Therefore, new biomarkers are warranted to estimate the metastatic risk, to detect metastatic spread at an early time point and to select the most effective systemic therapy in a given patient. This review gives an overview of liquid biopsy from blood in patients with advanced MIBC and considers CTCs, EVs as well as circulating DNA (ctDNA) and non-coding RNA (ncRNA) and their role for prognostic evaluation and selecting treatment.

Schlüsselwörter

Biomarker - Harnblasenkarzinome - zirkulierende Tumor-DNA - microRNA - zirkulierende Tumorzellen

Keywords

bladder cancer - biomarker - circulating tumor cells - circulating tumor DNA - microRNA

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