If the liquid biopsy, which makes it possible to diagnose cancers in a more precise and less expensive way, without surgery, seems revolutionary, some obstacles remain to be overcome before a generalization of this method.
Microfluidics is the science of manipulating fluids at the micrometric scale. At present, this area of research is exploding. So much so that more than 250 companies and 250 research teams are working on it around the world. The number of applications is considerable, whether in energy, cosmetics, the food industry or health. In the medical sector, one of the most promising applications is liquid biopsy, which helps in better diagnosis of cancer and should be generalized by 2030. But if this technique seems revolutionary, some limits still remain.
The liquid biopsy makes it possible to recover circulating tumor cells and thus to collect a maximum of information on the composition of the tumor and its stage of development, without any surgical intervention. Valerie Talydirector of research at the National Center for Scientific Research (CNRS), interviewed by Fréquence Médicale, explains: this method “consists of analyzing elements from the tumor in the biological effluents of patients. It can be circulating tumor cells and for a very long time it was essentially the case, but we can also have other biological elements including circulating tumor DNA which is the element on which we are particularly working”, explains. -she.
Clinical biopsy remains a research tool
In addition to blood, it is possible to find elements of the tumor in other liquids such as urine, semen or saliva, which makes it possible to dispense with traditional tissue biopsies, which can be risky for patients.
And if many works have already shown the interest of this practice, whether for monitoring therapeutic efficacy for cancer patients, for detecting recurrence, tumor progression or surgical efficacy, Currently, it remains a research tool.
Demonstrate the clinical interest of monitoring biological markers
“We have to be able to demonstrate the interest for the patient of monitoring these biological markers in the blood. Likewise, you have to make sure you have the right controls to be sure of what you are analyzing and not give bad results to patients”, explains the Professor Jerome Bibettephysicist and chemist, specialist in microfluidics and director of the Chemistry Biology Innovation Institute (ESPCI) at Frequency Medical.
Because despite major technological progress such as techniques for capturing circulating tumor cells (CTC), products derived from circulating tumors, or next-generation DNA sequencing adapted to circulating material, the clinical utility of these markers remains debated. . At present, “the only clinical indication approved by the regulatory agencies remains the search for EGFR mutations in non-small cell lung cancer”, explains Professor Jean-Yves Pierga, specialist in oncology at the Institute. Curie on the specialist site Edimark.fr.
“The use of CTCs or tcDNA as tools for the early detection of a primary tumor or a recurrence remains a subject of very active clinical research, but is not, in the absence of clinical evidence, usable routinely”, he concludes, noting however the interest of these markers as tools for deciphering the mechanisms of the metastatic process.
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