Cited by 16Sarcoma Diagnosis and TreatmentCancer Genomics and DiagnosticsBone Tumor Diagnosis and Treatments

Precision medicine in diagnosis, prognosis, and disease monitoring of bone and soft tissue sarcomas using liquid biopsy: A systematic review

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Smolle, Maria Anna, Seidel, Markus G., Kashofer, Karl, Liegl-Atzwanger, Bernadette, Sadoghi, Patrick, Müller, Daniel A., Leithner, Andreas·2025·Archives of Orthopaedic and Trauma Surgery

Abstract

INTRODUCTION: Liquid biopsy as a non-invasive method to investigate cancer biology and monitor residual disease has gained significance in clinical practice over the years. Whilst its applicability in carcinomas is well established, the low incidence and heterogeneity of bone and soft tissue sarcomas explains the less well-established knowledge considering liquid biopsy in these highly malignant mesenchymal neoplasms. MATERIALS AND METHODS: A systematic literature review adhering to the PRISMA guidelines initially identified 920 studies, of whom 68 original articles could be finally included, all dealing with clinical applicability of liquid biopsy in sarcoma. Studies were discussed within two main chapters, i.e. translocation-associated and complex-karyotype sarcomas. RESULTS: Overall, data on clinical applicability of liquid biopsy in 2636 patients with > 10 different entities of bone and soft tissue sarcomas could be summarised. The five most frequent tumour entities included osteosarcoma (n = 602), Ewing sarcoma (n = 384), gastrointestinal stromal tumour (GIST; n = 203), rhabdomyosarcoma (n = 193), and leiomyosarcoma (n = 145). Of 11 liquid biopsy analytes, largest evidence was present for ctDNA and cfDNA, investigated in 26 and 18 studies, respectively. CONCLUSIONS: This systematic literature review provides an extensive up-to-date overview about the current and potential future uses of different liquid biopsy modalities as diagnostic, prognostic, and disease monitoring markers in sarcoma.

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  • Sarcoma diversity includes distinct molecular architectures ranging from translocation-associated tumors with relatively simple genomic profiles to complex-karyotype sarcomas with widespread copy-number alterations, structural instability, methylation changes, and substantial intertumoral heterogeneity.

    “Their diversity extends beyond histology to include distinct molecular architectures, ranging from translocation-associated tumors with relatively simple genomic profiles to complex-karyotype sarcomas characterized by widespread copy-number alterations, structural instability, methylation changes, and substantial intertumoral heterogeneity [ 3 , 4 ].”

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  1. [8]Group OLoEW (2011) The Oxford 2011 levels of evidence. Oxford Centre for Evidence-Based Medicine, Oxford
  2. [25]Shukla NN, Patel JA, Magnan H, Zehir A, You D, Tang J et al (2017) Plasma DNA-based molecular diagnosis, prognostication, and monitoring of patients with EWSR1 fusion-positive sarcomas. JCO Precis Oncol 2017:1–11 PMC5881916 29629425

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Authors
Smolle, M. A., Seidel, M. G., Kashofer, K., Liegl-Atzwanger, B., Sadoghi, P., Müller, D. A., & Leithner, A.
Affiliations
  • Medical University of Graz (AT)
  • University of Zurich (CH)
Corresponding author
Leithner, Andreas
Venue
Archives of Orthopaedic and Trauma Surgery
Published
2025-01-11
Volume
145
Issue
1
Pages
121-121
ISSN
  • 0936-8051 (ISSN-L)
  • 1434-3916
OpenAlex
W4406274630
Cited by
16
References
83
Citations by year
2026: 16
FWCI
2.76
Type
journal article
Language
en
Open access
Locations
  • Archives of Orthopaedic and Trauma Surgery (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
Funders
Medical University of Graz
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
  • Health Sciences › Medicine › Rheumatology › Bone Tumor Diagnosis and Treatments
Keywords
liquid biopsy, bone and soft tissue sarcoma, osteosarcoma, Ewing sarcoma, gastrointestinal stromal tumor, rhabdomyosarcoma, leiomyosarcoma, circulating tumor DNA, cell-free DNA, disease surveillance, prognosis, diagnosis
MeSH terms
Liquid Biopsy, Bone Neoplasms, Humans, Prognosis, Sarcoma, Osteosarcoma, Soft Tissue Neoplasms, Biomarkers, Tumor, Precision Medicine

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