Liquid Biopsy in Gastrointestinal Stromal Tumors: Ready for Prime Time?
David Gómez-PeregrinaAlfonso García-ValverdeDaniel Pilco-JanetaCesar SerranoPublished in: Current treatment options in oncology (2021)
Gastrointestinal stromal tumor (GIST) constitutes a paradigm for clinically effective targeted inhibition of oncogenic driver mutations. Therefore, GIST has emerged as a compelling clinical and biological model to study oncogene addiction and to validate preclinical concepts for drug response and drug resistance. Oncogenic activation of KIT or PDGFRA receptor tyrosine kinases is the essential drivers of GIST progression throughout all stages of the disease. Interestingly, KIT/PDGFRA genotype predicts the response to first-line imatinib and to all tyrosine kinase inhibitors (TKIs) approved or in investigation after imatinib failure. Considering that TKIs are effective only against a subset of KIT or PDGFRA resistance mutations, close monitoring of tumor dynamics with non-invasive methods such as liquid biopsy emerges as a necessary step forward in the field. Liquid biopsy, in contrast to solid tumor biopsy, aims to characterize tumors irrespective of heterogeneity. Although there are several components in the peripheral blood, most recent studies have been focused on circulating tumor (ct)DNA, due to the technological feasibility, the stability of DNA itself and DNA alterations, and the therapeutic development in precision oncology largely based on the identification of genetic driver mutations. In the present review, we systematically dissect the current wealth of data of ctDNA in GIST. To do so, a critical understanding of the promises and limitations of the current technologies will be followed by an exposition of the knowledge gathered with such studies in GIST. Collectively, our goal is to establish clear premises that can be used as the foundations to build future studies towards the clinical implementation of ctDNA evaluation in GIST patients.
Keyphrases
- circulating tumor
- cell free
- circulating tumor cells
- ultrasound guided
- fine needle aspiration
- peripheral blood
- healthcare
- end stage renal disease
- chronic myeloid leukemia
- case control
- ionic liquid
- ejection fraction
- magnetic resonance
- transcription factor
- newly diagnosed
- primary care
- chronic kidney disease
- computed tomography
- gene expression
- palliative care
- prognostic factors
- magnetic resonance imaging
- contrast enhanced
- stem cells
- machine learning
- quality improvement
- image quality
- single molecule
- cell therapy
- mesenchymal stem cells
- peritoneal dialysis
- single cell
- electronic health record