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Open AccessArticle

Liquid Biopsies in Lung Cancer: Four Emerging Technologies and Potential Clinical Applications

Department of Life Sciences, Brunel University, London UB83PH, UK
Division of Thoracic Surgery, The Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, London UB9 6JH, UK
College of Engineering, Mathematics and Physical Sciences University of Exeter, Exeter EX4 4QF, UK
Chronix Biomedical, 37073 Göttingen, Germany
Mount Vernon Cancer Centre, Middlesex HA6 2RN, UK
Department of Oncology and Reconstructive Surgery, Sechenov First Moscow State Medical University, Moscow 119146, Russia
Authors to whom correspondence should be addressed.
Cancers 2019, 11(3), 331;
Received: 1 February 2019 / Accepted: 28 February 2019 / Published: 7 March 2019
(This article belongs to the Special Issue Molecular Profiling of Lung Cancer)
Background: Liquid biopsies offer a promising alternative to tissue samples, providing non-invasive diagnostic approaches or serial monitoring of disease evolution. However, certain challenges remain, and the full potential of liquid biopsies has yet to be reached. Here we report several methodological approaches to interrogate liquid biopsies using circulating tumour cell (CTC) enumeration and characterisation, transcriptomics, Raman spectroscopy, and copy number instability (CNI) scores using blood samples of lung cancer (LC) patients. Methods: We choose LC; since it still is the most common cause of cancer-related mortality worldwide, and therefore there is a need for development of new non-invasive diagnostic/prognostic technologies. Changes in gene expression were assessed using RNA-seq, and in CTCs using ImageStream, an imaging flow-cytometer. CNI scores, from paired tissue/ctDNA were also explored. Raman spectroscopy was used to provide chemical fingerprints of plasma samples. Results: CTCs were detected in all LC patients (n = 10). We observed a significant increase in CTC levels in LC patients (n = 10) compared to controls (n = 21). A similar CNI was noted in the tissue and plasma of 2 patients, where higher CNI scores corresponded with poorer outcome. Significant changes in Raman spectra (carotenoid concentrations) were noted in LC patients (n = 20) compared to controls (n = 10). RNA-seq revealed differential expression of 21 genes between LC cases and controls in both LC tissue and blood samples. Conclusions: Liquid biopsies can potentially provide a more comprehensive picture of the disease compared to a single tissue biopsy. CTC enumeration is feasible and sensitive for LC patients. Molecular profiling of CTCs is also possible from total blood. CNI scores and Raman spectra require further investigation. Further work is being undertaken to explore these methods of detection in a larger LC cohort. View Full-Text
Keywords: liquid biopsies; circulating tumour cells; lung cancer; copy number instability; Raman spectroscopy liquid biopsies; circulating tumour cells; lung cancer; copy number instability; Raman spectroscopy
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Chudasama, D.; Katopodis, P.; Stone, N.; Haskell, J.; Sheridan, H.; Gardner, B.; Urnovitz, H.; Schuetz, E.; Beck, J.; Hall, M.; Barr, J.; Sisu, C.; Rice, A.; Polychronis, A.; Anikin, V.; Karteris, E. Liquid Biopsies in Lung Cancer: Four Emerging Technologies and Potential Clinical Applications. Cancers 2019, 11, 331.

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