Liquid biopsies: the future of cancer early detection

Abstract

Cancer is a worldwide pandemic. The burden it imposes grows steadily on a global scale causing emotional, physical, and financial strains on individuals, families, and health care systems. Despite being the second leading cause of death worldwide, many cancers do not have screening programs and many people with a high risk of developing cancer fail to follow the advised medical screening regime due to the nature of the available screening tests and other challenges with compliance. Moreover, many liquid biopsy strategies being developed for early detection of cancer lack the sensitivity required to detect early-stage cancers. Early detection is key for improved quality of life, survival, and to reduce the financial burden of cancer treatments which are greater at later stage detection. This review examines the current liquid biopsy market, focusing in particular on the strengths and drawbacks of techniques in achieving early cancer detection. We explore the clinical utility of liquid biopsy technologies for the earlier detection of solid cancers, with a focus on how a combination of various spectroscopic and -omic methodologies may pave the way for more efficient cancer diagnostics.

Keywords: Cancer; Diagnostics; Early detection; Liquid biopsy; Multi-cancer.

Fig. 1

Cancer progression with time, data adapted from [19]

Fig. 2

Five-year relative survival for selected cancers by stage at diagnosis, United States 2011 to 2017. Adapted from [21]

Fig. 3

Patient cancer cost associated with the first 12 months averaged over 11 cancer types (bladder, breast, colorectal, esophagus, kidney, liver, lung, ovary, pancreas, prostate and stomach), data adapted from [22]. Survival rates, averaged from SEER 5 -Year Survival Rates 2012–2018 across 11 cancer types (bladder, female breast, colorectal, esophagus, kidney, liver and intrahepatic bile duct, lung and bronchus, ovary, pancreas, prostate and stomach) data from both sexes unless stated otherwise, calculated from [28]

Fig. 4

Acting across the diagnostic pathway, adapted from [35]

Fig. 5

Tumor and non-tumor derived information prevalence varying with stage, adapted from [46]

Fig. 6

Liquid biopsy inclusive signal analysis

Fig. 7

An effective test for multi-cancer detection can be achieved through a combination of various technologies