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. 2023 Jan 4;11(1):8. doi: 10.3390/medsci11010008

Table 1.

Advantages and challenges of single substrates used for liquid biopsy.

Substrate Advantages Challenges
cfDNA
  • -

    Easy to isolate

  • -

    Stable

  • -

    Proportion related to tumor burden and overall survival
  • -

    Prior knowledge of the target of interest

  • -

    Limitation of available material

  • -

    Blood cell death under therapy could spike cfDNA fraction

  • -

    Source not clear

  • -

    Large background of ”normal” cfDNA
CTCs
  • -

    Prognostic in all stages

  • -

    Matching mutation with tumor subclones

  • -

    Intact cells could be resistant clones

  • -

    Functional assays

  • -

    Culture
  • -

    Difficult to isolate

  • -

    Sampling bias of captured cells

  • -

    Single-cell/low cell number sequencing challenging
miRNA
  • -

    Early diagnosis

  • -

    Predictors of diagnosis, prognosis and response to therapies

  • -

    High accuracy, sensitivity and specificity

  • -

    Associated with overall survival
  • -

    Not stable

  • -

    High variability

  • -

    miRNA detection and quantification pre-analytical steps not validated

  • -

    Non-specificity for a type of cancer
Exosomes
  • -

    Contain various biomolecules (proteins, RNAs and lipids)

  • -

    Stable

  • -

    Selection of patients with poor outcomes based on size

  • -

    More sensitive to the identification of relevant mutations than that of cfDNA.
  • -

    Difficult to isolate

  • -

    No or minimal overlap occurs across the studies, strongly limiting their clinical usefulness.