fgene-14-1345876

TYPE Editorial
PUBLISHED 14 December 2023

DOI 10.3389/fgene.2023.1345876
Editorial: Current trends and

OPEN ACCESS future perspectives about liquid
EDITED AND REVIEWED BY
Anton A. Buzdin,
European Organisation for Research and
biopsy
Treatment of Cancer, Belgium
*CORRESPONDENCE Elisa Frullanti 1,2* and María José Serrano 3,4,5

Elisa Frullanti, 1
elisa.frullanti@dbm.unisi.it Cancer Genomics and Systems Biology Laboratory, Department of Medical Biotechnologies, University
of Siena, Siena, Italy, 2Department of Medical Biotechnologies, Med Biotech Hub and Competence
RECEIVED 28 November 2023 Centre, University of Siena, Siena, Italy, 3GENYO Centre for Genomics and Oncological Research, Pfizer/
ACCEPTED 05 December 2023 University of Granada/Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group,
PUBLISHED 14 December 2023 PTS Granada, Granada, Spain, 4Biomedical Research Institute IBS-Granada, Granada, Spain, 5Integral
Oncology Division, Virgen de las Nieves University Hospital, Granada, Spain
CITATION
Frullanti E and Serrano MJ (2023),
Editorial: Current trends and future
KEYWORDS
perspectives about liquid biopsy.
Front. Genet. 14:1345876. human cancer, liquid biopsy, cancer biomarkers, circulating cancer molecules, disease
doi: 10.3389/fgene.2023.1345876 monitoring
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© 2023 Frullanti and Serrano. This is an
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Editorial on the Research Topic
forums is permitted, provided the original Current trends and future perspectives about liquid biopsy
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which does not comply with these terms.
Introduction
Despite rapid advancements in cancer screening and therapies, many cancer patients still
succumb to the disease. The molecular characteristics of tumors are commonly assessed
using surgical specimens or biopsy samples. However, biopsies only sample a portion of the
tumor and might not fully represent its heterogeneity, providing incomplete information
about the genetic variability of a patient’s cancer. Additionally, it is impractical for patients to
undergo multiple biopsies of primary and metastatic lesions as the tumor progresses.
During the last years, to answer the need of a more accessible approach for tumor genetic
analysis, liquid biopsy has emerged as an innovative, minimally-invasive and efficient
opportunity of detecting and monitoring cancer in several body fluids instead of tumor
tissue. Furthermore, thanks to this approach, we are able to take more blood samples over
time, informing about the type of molecular changes going on in a tumor. Circulating tumor
DNA (ctDNA), Circulating tumor cells (CTCs), RNA (mRNA and microRNA),
microvesicles, including exosomes and tumor educated platelets represent a source of
genomic information in cancer patients reflecting all subclones present in primary and
metastatic lesions allowing sequential monitoring of disease evolution.
This Research Topic aimed to update the currently available information concerning liquid
biopsy, the key features and their applications in oncology highlighting the technological
challenges and the hurdles we need to overcome to finally see the next era of cancer care.
Most innovative features of liquid biopsy

The reviews and original articles published in the present Research Topic updated about the
key and most innovative features of liquid biopsy and their applications in oncology. In particular,
Frontiers in Genetics 01 frontiersin.org

Frullanti and Serrano 10.3389/fgene.2023.1345876
Liu et al. assessed the potential utility of miRNAs as biomarkers and Conclusion
highlighted certain promising candidates for liquid biopsy approach in
the diagnosis and management of breast cancer that may optimize the In conclusion, this Research Topic highlights the importance of
patient outcome. They highlighted how some miRNAs, including miR- liquid biopsy approach in revolutionizing cancer precision medicine.
21 and miR-155, were found to play an important role in breast cancer The key findings discussed herein demonstrated the increasing
progression as well as in breast cancer management. significance of the multi-omics and multi-markers analysis for the
Similarly, Palmieri et al. assessed the diagnostic performance of identification of new biomarkers, which may prove useful for diagnosis,
cell free DNA analysis for the detection of KRAS mutations in non- prognosis and management of cancer patients.
small cell lung cancer, compared to tissues, through a meta-analysis
and systematic review. The analysis of 40 studies including more
than 2,800 NSCLC patients revealed that the detection of KRAS Author contributions
mutation in cfDNA has an adequate diagnostic accuracy and might
be a valid alternative for molecular analysis when tumor biopsy or EF: Conceptualization, Data curation, Writing–original draft,
cytological specimens are not available. Project administration, Supervision, Writing–review and editing.
Di Sario et al. highlighted the importance of an integrated multi- MS: Conceptualization, Validation, Writing–review and editing,
omic, multi-analyte approach of liquid biopsy in the research of Project administration, Writing–original draft.
novel prognostic and predictive biomarkers for cancer as well as in
the monitoring of the course of the disease.
Finally, Zhao et al. focused their attention on ctDNA analysis for Funding
prognosis prediction in Chinese newly diagnosed follicular lymphoma
patients with interesting results. The most commonly mutated genes The author(s) declare that no financial support was received for
were CREBBP, KMT2D, STAT6, CARD11, PCLO, EP300, BCL2, and the research, authorship, and/or publication of this article.
TNFAIP3. Patients with detectable ctDNA mutation tended to present
with advanced stages. In particular, Progression-Free Survival resulted
shorter in patients with KMT2D, EP300 and STAT6 mutations. Acknowledgments
Beyond nucleic acids, the presence of Circulating Tumor Cells
(CTCs) has been acknowledged as an independent prognostic marker We deeply thank all the authors and reviewers who have
in various solid tumors, including breast, colon, and prostate cancer. The participated in this Research Topic.
prognostic value was demonstrated 20 years ago by Cristofanilli et al.
(2004) and Gaforio et al. (2003) in breast cancer patients (Gaforio et al.,
2003; Cristofanilli et al., 2004). Recent approaches have aimed to Conflict of interest
comprehend the biology of these CTCs. Consequently, the assessment
of circulating tumor cells (CTCs) allows for repeated sampling to identify The authors declare that the research was conducted in the
the genomic instability of the tumor. Identifying EGFR and KRAS absence of any commercial or financial relationships that could be
mutations is crucial in guiding the treatment of non-small cell lung construed as a potential conflict of interest.
cancer (NSCLC) patients undergoing EGFR tyrosine kinase inhibitors The author(s) declared that they were an editorial board
and colorectal cancer patients receiving anti-EGFR therapy, respectively. member of Frontiers, at the time of submission. This had no
The comparison of mutations between CTCs and corresponding primary impact on the peer review process and the final decision.
or metastatic tumor tissue has generated significant interest.
Meanwhile, Extracellular Vesicles (EVs) circulating tumor-derived
endothelial cells (CTECs), and tumor-educated blood platelets (TEPs), Publisher’s note
considered as carriers of molecular information shed by tumors, have
gained attention due to their potential in providing valuable genetic and All claims expressed in this article are solely those of the authors
proteomic data for cancer diagnostics and monitoring (Mehran et al. and do not necessarily represent those of their affiliated
2014; Liu et al., 2020; Yu et al., 2021) Including examples of these organizations, or those of the publisher, the editors and the
different LBs, widely present in plasma, urine, ascites, and other body reviewers. Any product that may be evaluated in this article, or
fluids, broadens our understanding of liquid biopsy technologies and claim that may be made by its manufacturer, is not guaranteed or
their applications in diverse cancer types. endorsed by the publisher.
References
Cristofanilli, M., Budd, G. T., Ellis, M. J., Stopeck, A., Matera, J., Miller, M. C., Liu, L., Lin, F., Ma, X., Chen, Z., and Yu, J. (2020). Tumor-educated platelet as liquid biopsy in
et al. (2004). Circulating tumor cells, disease progression, and survival in lung cancer patients. Crit. Rev. Oncol. Hematol. 146, 102863. doi:10.1016/j.critrevonc.2020.102863
metastatic breast cancer. N. Engl. J. Med. 351 (8), 781–791. doi:10.1056/
Mehran, R., Nilsson, M., Khajavi, M., Du, Z., Cascone, T., Wu, H. K., et al. (2014). Tumor
NEJMoa040766.PMID:15317891
endothelial markers define novel subsets of cancer-specific circulating endothelial cells associated
Gaforio, J. J., Serrano, M. J., Sanchez-Rovira, P., Sirvent, A., Delgado-Rodriguez, M., with antitumor efficacy. Cancer Res. 74 (10), 2731–2741. doi:10.1158/0008-5472.CAN-13-2044
Campos, M., et al. (2003). Detection of breast cancer cells in the peripheral blood is positively
Yu, W., Hurley, J., Roberts, D., Chakrabortty, S. K., Enderle, D., Noerholm, M., et al.
correlated with estrogen-receptor status and predicts for poor prognosis. Int. J. Cancer 107 (6),
(2021). Exosome-based liquid biopsies in cancer: opportunities and challenges. Ann.
984–990. doi:10.1002/ijc.11479
Oncol. 32 (4), 466–477. doi:10.1016/j.annonc.2021.01.074
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TYPE Editorial

PUBLISHED 14 December 2023

Editorial: Current trends and

CORRESPONDENCE Elisa Frullanti 1,2 and María José Serrano 3,4,5

Most innovative features of liquid biopsy

Frontiers in Genetics 01 frontiersin.org

Frontiers in Genetics 02 frontiersin.org

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