New England Journal of Medicine,
Год журнала:
2021,
Номер
384(21), С. 2039 - 2052
Опубликована: Май 26, 2021
DNA
mutations
occur
in
nearly
every
tissue
throughout
the
human
life
span
and
accumulate
at
various
rates
different
tissues
according
to
intrinsic
extrinsic
factors.
If
a
mutated
clone
acquires
features
that
confer
competitive
advantage,
clonal
dominance
can
emerge.
Such
alterations
have
functional
consequences
cause
disease.
As
people
age,
their
tissues
accumulate
an
increasing
number
of
somatic
mutations.
Although
most
these
mutations
are
little
or
no
functional
consequence,
a
mutation
may
arise
that
confers
fitness
advantage
on
cell.
When
this
process
happens
in
the
hematopoietic
system,
substantial
proportion
circulating
blood
cells
derive
from
single
mutated
stem
This
outgrowth,
called
"clonal
hematopoiesis,"
is
highly
prevalent
elderly
population.
Here
we
discuss
recent
advances
our
knowledge
clonal
hematopoiesis,
its
relationship
to
malignancies,
link
nonmalignant
diseases
aging,
and
potential
impact
immune
function.
Clonal
hematopoiesis
provides
glimpse
into
selection
likely
occurs
all
tissues.
Annals of Oncology,
Год журнала:
2022,
Номер
33(8), С. 750 - 768
Опубликована: Июль 6, 2022
•Validated
and
sensitive
ctDNA
assays
can
be
used
to
genotype
advanced
cancers
select
patients
for
targeted
therapies.•Initial
genotyping
with
should
considered
when
rapid
results
are
needed,
tissue
is
unavailable.•ctDNA
assay
limited
by
false-negative
results,
lower
sensitivity
fusion
events
copy
number
changes.•Use
of
detect
molecular
residual
disease
not
recommended,
due
lack
evidence
its
clinical
utility.
Circulating
tumour
DNA
(ctDNA)
conducted
on
plasma
rapidly
developing
a
strong
base
use
in
cancer.
The
European
Society
Medical
Oncology
convened
an
expert
working
group
review
the
analytical
validity
utility
assays.
For
cancer,
validated
adequately
have
identifying
actionable
mutations
direct
therapy,
may
routine
practice,
provided
limitations
taken
into
account.
Tissue-based
testing
remains
preferred
test
many
cancer
patients,
detecting
changes,
although
routinely
faster
will
clinically
important,
or
biopsies
possible
inappropriate.
Reflex
following
non-informative
result,
testing.
In
treated
early-stage
cancers,
detection
relapse,
has
high
anticipating
future
relapse
cancers.
Molecular
disease/molecular
cannot
recommended
as
currently
there
no
directing
treatment.
Additional
potential
applications
assays,
under
research
development
include
responding
therapy
early
dynamic
changes
levels,
monitoring
resistance
before
progression,
screening
asymptomatic
people
Recommendations
reporting
made.