PT - JOURNAL ARTICLE AU - Lavanya Sivapalan AU - Joseph C Murray AU - Jenna VanLiere Canzoniero AU - Blair Landon AU - Jennifer Jackson AU - Susan Scott AU - Vincent Lam AU - Benjamin P. Levy AU - Mark Sausen AU - Valsamo Anagnostou TI - Liquid biopsy approaches to capture tumor evolution and clinical outcomes during cancer immunotherapy AID - 10.1136/jitc-2022-005924 DP - 2023 Jan 01 TA - Journal for ImmunoTherapy of Cancer PG - e005924 VI - 11 IP - 1 4099 - http://jitc.bmj.com/content/11/1/e005924.short 4100 - http://jitc.bmj.com/content/11/1/e005924.full SO - J Immunother Cancer2023 Jan 01; 11 AB - Circulating cell-free tumor DNA (ctDNA) can serve as a real-time biomarker of tumor burden and provide unique insights into the evolving molecular landscape of cancers under the selective pressure of immunotherapy. Tracking the landscape of genomic alterations detected in ctDNA may reveal the clonal architecture of the metastatic cascade and thus improve our understanding of the molecular wiring of therapeutic responses. While liquid biopsies may provide a rapid and accurate evaluation of tumor burden dynamics during immunotherapy, the complexity of antitumor immune responses is not fully captured through single-feature ctDNA analyses. This underscores a need for integrative studies modeling the tumor and the immune compartment to understand the kinetics of tumor clearance in association with the quality of antitumor immune responses. Clinical applications of ctDNA testing in patients treated with immune checkpoint inhibitors have shown both predictive and prognostic value through the detection of genomic biomarkers, such as tumor mutational burden and microsatellite instability, as well as allowing for real-time monitoring of circulating tumor burden and the assessment of early on-therapy responses. These efforts highlight the emerging role of liquid biopsies in selecting patients for cancer immunotherapy, monitoring therapeutic efficacy, determining the optimal duration of treatment and ultimately guiding treatment selection and sequencing. The clinical translation of liquid biopsies is propelled by the increasing number of ctDNA-directed interventional clinical trials in the immuno-oncology space, signifying a critical step towards implementation of liquid biopsies in precision immuno-oncology.