A researcher at Stanford University holding a tube of blood after centrifugation. The pale yellow liquid on top is blood plasma containing cell-free DNA. Cell-free DNA in easy-to-obtain samples such as blood or urine is revolutionizing precision medicine approaches in many fields of medicine including oncology

With all the buzz surrounding liquid biopsies, people might think circulating cell-free DNA (cfDNA) is a new discovery. Not so, according to Iwijn De Vlaminck, Ph.D., assistant professor of biomedical engineering, Cornell University: “cfDNA was actually discovered in the 1940’s, even before the structure of double-stranded DNA. With the advent of genomics and molecular technologies, it’s all of a sudden becoming very relevant for a wide range of applications.”

Cancer cfDNA applications are among those on the verge of entering the clinical mainstream. Significant amounts of tumor-specific cfDNA are found in patients’ bloodstreams and other biological fluids such as urine.

The popular term “liquid biopsy” contrasts cfDNA, obtained from biological fluids, with classic tissue biopsy approaches. Both blood- and urine-based liquid biopsies are possible with Trovagene’s Precision Cancer Monitoring approach, which is designed to track specific oncogene mutations over time. According to company CSO Mark Erlander, Ph.D., urine can be “a more viable liquid biopsy than even plasma for some clinical utilities.”

Drs. De Vlaminck and Erlander were among the presenters at CHI’s Clinical Applications of Cell-Free DNA, a conference recently held in Washington, DC. Some of the most promising technologies presented there are discussed herein.

Be it from natural apoptotic turnover or aberrant cell death processes, “the components of dead cells don’t disappear magically,” maintained Dr. De Vlaminck. “Bits and pieces can end up in the bloodstream, and so can their genomes. cfDNA is basically DNA that floats around in blood. It’s not contained within cells. It’s essentially remnants of dead cells.”

“It’s a bit of a gold rush,” declared Dr. De Vlaminck. “The gold comes into play because there’s so many useful cfDNA applications, including prenatal, cancer, transplants, infection, and disease, where new approaches can have an impact. Lots of people are attracted to the promise of that.”

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