Cell-free DNA in hepatocellular carcinoma

Abstract For hepatocellular carcinoma patients, DNA for molecular profiling is obtained from resected tumor material or, occasionally, biopsies, neither of which is available for many patients. The urgent need for an alternative and reliable source of tumor DNA has led to the investigation of circulating cell-free DNA (cfDNA) assays. Circulating cfDNA is shed into bloodstream by living, necrotic, and apoptotic cells. The detection of cfDNA derived from cancer cells provides a new tool for cancer detection, genotype-guided precision medicine, and disease monitoring, all of which are critical to improving the prognosis of patients with hepatocellular carcinoma. Although cfDNA shows promising potential as a surrogate to assess the molecular profile of tumors, there remain challenges to be addressed, before cfDNA assays can be implemented into clinical practice.