Minimally invasive biopsy-based diagnostics in support of precision cancer medicine

Abstract

Precision cancer medicine (PCM) to support the treatment of solid tumors requires minimally invasive diagnostics. Here, we describe the development of fine-needle aspiration biopsy-based (FNA) molecular cytology which will be increasingly important in diagnostics and adaptive treatment. We provide support for FNA-based molecular cytology having a significant potential to replace core needle biopsy (CNB) as a patient-friendly potent technique for tumor sampling for various tumor types. This is not only because CNB is a more traumatic procedure and may be associated with more complications compared to FNA-based sampling, but also due to the recently developed molecular methods used with FNA. Recent studies show that image-guided FNA in combination with ultrasensitive molecular methods also offers opportunities for characterization of the tumor microenvironment which can aid therapeutic decisions. Here we provide arguments for an increased implementation of molecular FNA-based sampling as a patient-friendly diagnostic method, which may, due to its repeatability, facilitate regular sampling that is needed during different treatment lines, to provide tumor information, supporting treatment decisions, shortening lead times in healthcare, and benefit healthcare economics.

Keywords: biomarkers; fine‐needle aspirates; immune signaling; minimally invasive diagnostics; solid tumors; tumor microenvironment.

Fig. 1

FNA in cancer diagnostics. Bibliometric analysis of 10 549 publications during the period 2012–2022. (A) Bibliometric analysis of the number of publications (#) with geolocations show predominant usage of FNA in North America, Europe, and East Asia. (B) Co‐publication network analysis show predominant research units with > 30 publications during the period. (C) Distribution of publications based on cancer types over the period (see Table 1).