“With our experience in decades of clinical testing market assessment, we can say that multi-billion-dollar figures won’t happen so soon,” said Bruce Carlson, Publisher of Kalorama Information. “Such estimates, if grounded in any reality, takes all of cancer testing such as in situ hybridization and image cytology and standard biopsy of tissue and suggest replacement with liquid biopsy methods. IVD markets rarely are completely replaced like that.”
As the report indicates, physician practice trends, government regulation and incumbent technologies will see to that. However, a tenth of that estimate is certainly a possible market figure. Liquid biopsy is a term used for the overall concept, and is used to describe the specific nature of the test. The specific technologies are the following:
- Circulating tumor DNA (ctDNA) encompasses the small fragments of DNA that are believed to originate from the natural and abnormal necrosis and apoptosis processes that tumor cells undergo regularly. ctDNA fragments have the advantage of being available from different types of specimens, including urine, plasma, blood, and cerebrospinal fluid, but are rare and have a short half-life in the bloodstream, which makes their isolation and identification highly challenging. Since many cancer patients shed only very small DNA fragments into the bloodstream, ctDNA-based diagnostic technologies need to be highly sensitive in order to detect such rare events.
- Circulating tumor cells (CTCs) are cancer cells that are believed to detach from primary or secondary tumors and enter the bloodstream, traveling to distant organs, initiating the process of metastasis, and forming new tumors. Similarly to ctDNA, CTC-based tests could offer significant advantages compared to tissue biopsies, as they may be able to capture the heterogeneity of tumors and their genetic evolution during the disease progression and therapy. Compared to ctDNA, CTCs have a longer half-life in blood, and the analysis of viable cells could provide information about protein expression, such as PD-L1 or ER, which is not possible with ctDNA.
- Exosomes are nanometer-sized extracellular membrane vesicles secreted by cells in the extracellular environment on a continuous basis. Exosomes circulate in great abundance and are highly stable in all biological fluids, and contain molecular information from their parental cells, included in proteins and various nucleic acids. Moreover, exosomes are involved in many cellular processes and carry information about tumor growth, metastasis, and drug resistance, which is not available from the analysis of circulating free DNA.
Kalorama Information’s The Worldwide Market for Liquid Biopsy breaks out the market by these technology types and by cancer type. The report is available at: https://www.kaloramainformation.com/Worldwide-Liquid-Biopsy-Analyte-ctDNA-cfDNA-Application-Screening-Drug-Monitoring-Diagnostic-Region-Europe-Asia-ROW-Type-Cancer-10975987/