Liquid biopsy and tumor heterogeneity in metastatic solid tumors: The potentiality of blood samples.

Marco Russano, Andrea Napolitano, Giulia Ribelli, Michele Iuliani, Sonia Simonetti, Fabrizio Citarella, Francesco Pantano, Emanuela Dell'aquila, Cecilia Anesi, Nicola Silvestris, Antonella Argentiero, Antonio Solimando, Bruno Vincenzi, Giuseppe Tonini, Daniele Santini

Research output: Contribution to journalReview articlepeer-review


In a large number of cancer types, treatment selection depends on the presence of specific tumor biomarkers. Due to the dynamic nature of cancer, very often these predictive biomarkers are not uniformly present in all cancer cells. Tumor heterogeneity represents indeed one of the main causes of therapeutic failure, and its decoding remains a major ongoing challenge in the field. Liquid biopsy is the sampling and analysis of non-solid biological tissue often through rapid and non-invasive methods, which allows the assessment in real-time of the evolving landscape of cancer. Samples can be obtained from blood and most other bodily fluids. A blood-based liquid biopsy can capture circulating tumor cells and leukocytes, as well as circulating tumor-derived nucleic acids. In this review, we discuss the current and possibly future applications of blood-based liquid biopsy in oncology, its advantages and its limitations in clinical practice. We specifically focused on its role as a tool to capture tumor heterogeneity in metastatic cancer patients.

Original languageEnglish
Article number95
JournalJournal of Experimental and Clinical Cancer Research
Issue number1
Publication statusPublished - May 27 2020


  • Circulating tumor cells
  • Circulating tumor DNA
  • Liquid biopsy
  • microRNA
  • Peripheral blood mononuclear cells
  • Tumor heterogeneity

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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