Figure 1. The workflow of liquid biopsy using artificial intelligence and machine learning algorithms for early detection and personalized treatments of cancer.
Liquid biopsy, a minimally invasive and often blood-based test, detects circulating cancer-related genetic material such as tumor cells (CTCs), circulating tumor DNA (ctDNA), extracellular vesicles (EVs), tumor-educated platelets (TEPs), and circulating RNAs within body fluids. With the integration of artificial intelligence (AI) and machine learning (ML) algorithms, liquid biopsy can become more sensitive and precise in its analysis. Liquid biopsy can ultimately improve early detection, predict prognosis, and monitor treatment response in different cancers. AI models help liquid biopsy accomplish this by distinguishing tumor-generated ctDNA from hematopoietic cells and other non-malignant tissues through the liquid biopsy's low signal-to-noise ratio. From there, AI employs multilayered analytical techniques, exploiting distinct molecular features that identify ctDNA from normal cfDNA. This consists of somatic mutation detection, differential DNA methylation patterns, and copy number alterations. It also has the ability to detect epigenetic biomarkers on the DNA, indicating which organ the cancer originated from. Additionally, the DNA fragmentation as a result of cell death is detected by AI as "genomic fingerprints” that are identified to catch cancer at Stage I.
Liquid biopsy extends beyond diagnosis - it holds additional significance in its ability to generate prognostic insights, helping anticipate the likely trajectory of a patient’s disease. The non-invasive and repeatable nature of liquid biopsy permits long-term follow up, allowing clinicians to assess the disease evolution in real-time and appropriately respond to the therapy. Unlike a tissue biopsy that focuses on a specific area, a liquid biopsy focuses on the genetic material that represents the entire tumor heterogeneity, including sub-clonal mutations that can be missed by a tissue biopsy. Essentially, liquid biopsy provides a dynamic overview of tumor behavior. While its clinical application is constrained due to limited sensitivity, specificity, and a lack of standardization, liquid biopsy can be a significantly impactful tool to uncover genetic and molecular alterations that happen early in the development of cancer and provide circulating molecular tumor-derived material.
Links:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12839035/
https://pmc.ncbi.nlm.nih.gov/articles/PMC13064412/
