Study Explores Potential of Liquid Biopsy in Early-Stage NSCLC

Adding to the literature on the use of liquid biopsy in non–small cell lung cancer (NSCLC), a new study is reviewing different methods of liquid biopsy that may have potential in early-stage disease.

The study explores data on liquid biopsy approaches outside of circulating tumor DNA (ctDNA)—a commonly used approach for liquid biopsy—and includes novel methods like non-coding RNA (ncRNA).

RNAs originating from tumor cells include both coding and ncRNAs, the latter of which including a wide array of RNAs without translational ability, involving RNAs like micro RNAs (miRNAs), transfer RNAs, long ncRNAs (lncRNAs), circular RNAs (circRNAs), and small nuclear RNAs.

“The detection of ncRNA is a noninvasive, innovative approach for diagnosis,” wrote the researchers. “As potential biomarkers, ncRNAs were assessed for their ability to provide qualitative and quantitative information (e.g., expression levels), detect the mutational pattern in the transcript, and identify cancer-associated fusion transcripts or alternative splice variants. Among ncRNAs, miRNAs, lncRNAs, and recently characterized circRNAs are more suitable as biomarkers.”

According to the researchers, research has shown that both radiotherapy and chemotherapy can impact circulating miRNA, which may serve as an indicator of a therapy’s sensitivity early on in the treatment process, which has important implications for management decisions and avoiding unnecessary toxicities associated with therapies.

For example, miR-1246 and miR-1290 levels in serum were shown to impact NSCLC, with levels being associated with tumor stage and response to treatment. Levels of the miRNA increased substantially in NSCLC compared with healthy controls.

The researchers highlighted a second type of ncRNA that may serve as a potential biomarker in NSCLC: lncRNAs, which have also been linked with EGFR mutation.

“Recent research on lncRNA has revealed several potential biomarkers for the detection and prognosis of NSCLC,” explained the researchers. “lncRNAs XIST and HIF1A-AS1 were significantly elevated in serum samples of patients with NSCLC. Notably, these were significantly reduced after surgery. Patients with NSCLC and the control group were strongly separated in the ROC curve analysis (area under the curve (AUC) of XIST and HIF1A-AS1 were 0.834 and 0.876, respectively).”

Reference

Nagasaka M, Uddin M, Al-Hallak M, et al. Liquid biopsy for therapy monitoring in early-stage non-small cell lung cancer. Mol Cancer. 2021;20(1):82. doi:10.1186/s12943-021-01371-1