Liquid biopsies for diagnosing and monitoring primary tumors of the central nervous system.

Obtaining diagnostic specimens, notably to monitor disease course in cancer patients undergoing therapy, is an emerging area of research, however, with few clinical implications so far in the field of Neuro-oncology. Specifically for patients with primary brain tumors where repeat biosampling from the tumor and clinical decision making based on neuroimaging alone remain challenging, this area may assume a central role. In principle, sampling could focus on blood, cerebrospinal fluid or urine with differential sensitivities and specificities of findings that differ between specific parameters and target molecules. These include protein, mRNA, miRNA, cell-free DNA, either freely circulating or as cargo of extracellular vesicles, as well circulating tumor cells. The most solid biomarkers are those directly reflecting neoplastic disease, e.g., in the case of primary brain tumors isocitrate dehydrogenase mutation or epidermal growth factor receptor variant III. Importantly, the main goals of liquid biopsy marker development are to better understand response to therapy, natural evolution and emergence of resistant clones, rather than obviating the need for surgical interventions which remain to be a mainstay of therapy for the vast majority of primary brain tumors.

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Déclaration de conflit d'intérêts

Declaration of competing interest ELR has received research grants from Mundipharma and Amgen, honoraria for lectures or advisory board from Tocagen, Abbvie, Daiichy Sankyo, Mundipharma and Novartis. JS is a co-founder of Mosaic Biomedicals and Board member of Northern Biologics. He received grant/research support from Mosaic Biomedicals, Northern Biologics, Roche/Glycart, Isarna and Ridgeline. MS declares no conflicts of interest. RS has received honoraria for lectures or advisory board from Boards from MSD, Roche, Merck Serono, Celldex Therapeutics, Novartis, Mundipharma and Puma Technologies. MW has received research grants from Abbvie, Adastra, Bristol Meyer Squibb (BMS), Dracen, Merck, Sharp & Dohme (MSD), Merck (EMD), Novocure, Piqur and Roche, and honoraria for lectures or advisory board participation or consulting from Abbvie, Basilea, Bristol Meyer Squibb (BMS), Celgene, Merck, Sharp & Dohme (MSD), Merck (EMD), Novocure, Orbus, Roche and Tocagen.