Forging a path to the use of liquid biopsy in the diagnosis of gliomas

Glioblastoma is the most common malignant central nervous system tumor in adults and has a poor prognosis. Molecular characterization is important for prognosis, treatment planning, and prediction of treatment response, but currently, this can only be done with tumor resection or biopsy, which are always invasive and frequently risky. Substantial advances have been made in obtaining molecular information of tumors through the analysis of products shed in body fluids. Known as “liquid biopsies,” these analyses could become a noninvasive technique to provide both diagnostic and prognostic information, guidance on treatment, and real-time information on tumor status throughout the course of the disease. A liquid biopsy could thus provide key information for adapting and personalizing treatment. However, it will be necessary to discern the best technique. Results will need to be validated in large series and based on results in tumor tissue, which is still the gold standard. However, if liquid biopsy results are validated in tumors, it will provide the means to avoid neurological injury secondary to the surgical procedure, which should be solely therapeutic as a debulking maneuver.