Book Section #16987

Abstract

In recent decades, increasing genetic knowledge of cancers, including renal cancer, has led to increased knowledge about the molecular pathogenicity of cancers and advances in cancer treatment. Despite all these advances, no molecular biomarkers have been introduced into routine clinical interventions for the prediction and prognosis of renal cancer. Current conventional methods for diagnosing cancer include radiological and histopathological evaluations, which have their limitations. A qualitative examination of the tumor is not possible in radiological and histopathological methods that have limitations in intermittent tumor monitoring due to their invasiveness and nonrepeatable. Various studies have shown that the genomic profile of cancer varies from local to the metastatic stage and also at different levels of systemic treatment and can have specific patterns. To achieve this pattern for disease management, there is a need for serial examination of the disease, which is not possible by tissue biopsy. In addition to the impossibility of serial examination in the tissue-based approach, the high cost and possibility of side risks such as bleeding, infection and the impracticality of taking a biopsy specimen in some complex anatomical situations (such as in metastases to the brain and bone), the tissue biopsy approach poses many challenges. Due to the limitations of existing methods, new approaches are needed to study prognostic and predictive genetic profiles to improve clinical outcomes and the quality of life of patients. One of these valuable approaches is a liquid biopsy that overcomes the problems posed by conventional methods. Liquid biopsy test is based on the examination of circulating tumor cells (CTCs), cell-free nucleic acids, extracellular vesicles (exosomes), and their cargo that are circulating in the blood or other body fluids. The term “liquid biopsy” was first coined by Pantel and Alix-Panabières in 2010. Liquid biopsy has potential applications from the diagnosis to the follow-up of various cancers, including renal cell cancer. Liquid biopsy is a minimally invasive test and can easily repeat and perform serial tests on cancer (to check for recurrence and response to treatment); it can show the heterogeneity of the tumor and its development. It also reduces the cost of hospitalization throughout the treatment process, and its results represent the whole tumor, not one part of it. Liquid biopsy, as a tool of progress in individual medicine, can increase the effectiveness and tolerability of treatment and reduce the cost of cancer treatment. © 2022 Elsevier Inc. All rights reserved.