Circulating Tumor BRAF Mutation and Personalized Thyroid Cancer Treatment

Common medical treatments have some difficulties for cancer therapy in a desire way because of resistance to current therapeutics. Personalized cancer therapy aims to understand the unique properties and dynamics of each patient’s cancer in order to provide the most rational and appropriate therapy. It is still under the debate that circulating tumor markers will take the place of standard tissue biopsy or will support it to guide us to the more effective interventions According to American Cancer Society 62,450 people diagnosed with thyroid cancer in 2015 and 1950 deaths will result from the disease. In spite of good prognosis of differentiated thyroid carcinoma (DTC), about five to ten percent of patients will develop metastasis and fail torespond to radioactive iodine (RAI), and other traditional therapies. The lack of effectivetherapies for DTC, resistant to radioiodine and traditional therapies is now being overcome by the development of targeted novel compounds.The published result related to a phase II clinical study in Philadelphia illustrated treating metastatic thyroid cancer patients with the targeted therapy Vemurafenib to establish the activity of Vemurafenib in patients with BRAFV600E-positive papillary thyroid. The large-scale drug screening that incorporates genomic and gene expression data is another breakthrough to identify drug response biomarkers that could inform optimal application of cancer drugs. It is a commonknowledge that a small piece of a tumor receiving after tissue biopsy doesn’t represent the whole tumor, let alone metastases. Liquid biopsy, which is a diagnostic concept, opens a newperspective for real time monitoring of cancer open a new perspective for tumor evaluation.Liquid biopsy is defined as circulating tumor cells (CTCs) and fragments of circulating tumorDNA (ctDNA) shed into the bloodstream from primary and metastatic tumor deposits. Using ofctDNA is superior as a non-invasive and cost effective solution to identify reliable biomarkers for measuring tumor growth, metastasis and response to treatments. Liquid biopsies could be used to guide cancer treatment strategy and perhaps even screen for tumors that are not yet visible on imaging. Take advances in molecular genetic technology into consideration, evaluation and characterization of circulating tumor markers can be the best alternative for realtime tumor tracking. In the near future tissue biopsy will be replaced by liquid biopsy and now is the exact time to focus on CTCs and ctDNA as a circulating tumor biomarker specifically in personalization of cancer treatment.

Keywords:

BRAF mutation , Thyroid Cancer , Personalized Medicine