Liquid Biopsy for Monitoring EC Patients: Towards Personalized Treatment

Abstract

Endometrial cancer (EC) is the most frequent gynecological cancer in developed countries and its incidence shows an increasing trend. Fortunately, the prognosis of the disease is good when the tumour is diagnosed in an early phase, but some patients recur after surgery and develop distant metastasis. The therapy options for EC for advanced disease are more limited than for other tumours. Therefore, the application of non-invasive strategies to anticipate the recurrence of localized tumours and guide the treatment in advanced stages represents a clear requirement to improve the survival and quality of life of patients with EC. To achieve this desired precision oncology, it is necessary to invest in the identification and validation of circulating markers that allow a more effective stratification and monitoring of patients. We here review the main advances made for the evaluation of circulating tumour DNA (ctDNA), circulating tumour cells (CTCs), circulating extracellular vesicles (cEVs), and other non-invasive biomarkers as a monitoring tool in the context of localized and advanced endometrial tumours, with the aim of providing a global perspective of the achievements and the key areas in which the use of these markers can be developed into a real clinical tool.

Keywords: endometrial cancer; liquid biopsy; monitoring markers; personalized medicine; therapy selection.

Figure 1

Clinical contexts for the application of liquid biopsy (CTCs, cfDNA, cEVs and miRNAs) to improve the management of patients with both localized and advanced EC. MRD, minimal residual disease. Figures: www.flaticon.com, www.smart.servier.com (accessed on 9 November 2021).