5 Upcoming Liquid Biopsy Trends in 2023

With robot servers, the metaverse, and automation, it is clear that we’ve officially entered the era of advanced technology. This is also true for the life sciences industry. Liquid biopsy has significantly improved over the past couple of years as a minimally invasive tool for diagnostic, prognostic, monitoring and treatment purposes. In 2023, liquid biopsy is often preferred over traditional tissue biopsy due to its high level of accuracy and ease of collection. Tissue biopsies, on the other hand, are invasive and sometimes risky to collect, and may lack accuracy due to sample heterogeneity. Therefore, researchers and clinicians have shifted to samples such as plasma, serum, urine, saliva, cerebrospinal fluid, amniotic fluid, and more. With this, we have seen major trends emerge in the scientific industry such as the use of saliva for COVID-19 testing or the use of cf-RNA from urine for prostate cancer screening.

The future of liquid biopsy is highlighted below with five upcoming trends to look forward to in 2023, including:

1. Non-Invasive Prenatal Testing
2. Mass Population Screening and Point-of-Care
3. RNA Therapeutics and Treatment Monitoring
4. Topical Use for Skincare
5. Precision Oncology

1. Non-Invasive Prenatal Testing

Non-invasive prenatal testing, also known as NIPT, is a new minimally invasive screening method to detect whether a fetus has any genetic abnormalities through a simple blood draw from the mother. From maternal plasma, researchers or clinicians are able to isolate fetal DNA that has been expelled from the placenta into the maternal bloodstream. With the isolated DNA, they are able to detect any trisomies, the most common being Down Syndrome (trisomy 21), Edwards Syndrome (trisomy 18) or Patau Syndrome (trisomy 13).¹

Before NIPT, the gold standard for trisomy testing was amniocentesis, which is a highly invasive procedure that involves inserting a needle into the amniotic sac to collect amniotic fluid. Although accurate, this test cannot be performed before the 14-week mark as there is a risk of miscarriage.² NIPT is not yet a replacement for amniocentesis and is only considered a pre-screening tool, however, with the emergence of new technologies to isolate and detect nucleic acids, NIPT could be the future for prenatal testing.

For more information, Norgen has created a seamless workflow for NIPT utilizing the plasma/serum sample type.

2. Mass Population Screening and Point-of-Care

Mass population screening is an old practice; in the 1980s, mass screening for breast cancer using mammography was implemented for early detection in hopes to reduce breast cancer mortality rates.³ However, as medical technology using liquid biopsy evolves, mass population screening has improved. This includes recent advancements in sample preservation, making mass population screening using point-of-care collection effortless.

In a study done by Martyn Webb and colleagues using Norgen’s Urine Preservation Tubes, it was determined that using the preservative for at-home urine collection resulted in the same quality of RNA compared to samples collected in the clinic and immediately processed.⁴ They found that with this at-home collection protocol, there was potential to perform large-scale prostate cancer studies while saving money, time and discomfort for the patient.⁴

As more and more techniques using liquid biopsies for detection are discovered, we could be seeing an increase in mass population screening for early diagnosis and in some cases, like HIV and HCV, a reduction in transmission and infection rates.

3. RNA Therapeutics and Treatment Monitoring

We’ve touched base on diagnosis and mass screening, but did you know liquid biopsies have the potential to be used in pharmaceutical industries?

The next liquid biopsy trend that we’ll be seeing in 2023 is the use of liquid biopsy for therapeutics and treatment monitoring, whether it’s cancer treatment or even potential therapies for other disorders like Duchenne muscular dystrophy.

In a study done by Masashi Fukuoka and his team using Norgen’s Plasma/Serum Circulating and Exosomal RNA Purification Mini Kit (Slurry Format), they found that there is a relation between aging and the miRNA in a patient's blood circulation, with the most notable being miR-199-3p, which plays a role in myogenic differentiation and muscle generation. Upon further studies, they determined that the administration of miR199#4 (a mimic of miR-199-3p) not only delayed the muscle loss due to aging in mice, but also increased the muscle strength when administered to MDX mice (mice mimicking Duchenne muscular dystrophy).⁵ With further studies, miR199#4 has the potential of becoming an RNA therapeutic for patients with muscle conditions and other age-related diseases.

With liquid biopsy potentially playing a key role in therapeutics, researchers will emphasize this treatment method as the field progresses.

4. Topical Use For Skincare

Skincare is one of the leading industries in the world and according to Statista, it is estimated that it will generate roughly $164 billion in 2023.⁶ The next trend we'll be discussing is the use of liquid biopsies and their contents for topical treatments. Yes… liquid biopsies for skin care.

Apart from the cell-free circulating nucleic acids, liquid biopsies contain small circulating extracellular vesicles called exosomes. These vesicles contain cargo such as miRNA, fragmented mRNA and proteins. As they are in charge of cell-to-cell communication, exosomes have mostly been used to study disease, however, recent studies have shown their potential for wound treatment and cosmetics.

According to Yang et al., the diverse cargo in exosomes makes it possible to have more than one therapeutic effect when it comes to skincare. For topical use, exosomes have the potential to enhance wound healing and provide an anti-aging effect as they increase angiogenic ability and collagen synthesis, as well as the potential to act as treatments for skin conditions like psoriasis due to the anti-inflammatory properties.⁷

Could exosomes be the new miracle cure for younger and healthier looking skin?

5. Precision Oncology (patient-to-patient specific-includes treatment plans, prognosis and monitoring)

Oncological applications of liquid biopsies have become an attractive alternative for researchers. While cancer research is not relatively new, precision oncology is, only being introduced in the last few decades. The future of cancer research is bright in 2023 as streamlined and simplified liquid biopsy is accelerating and qualitatively improving oncology.

Precision oncology is the patient-specific molecular profiling of tumour nucleic acids for monitoring and treatment purposes. This new technique has recently been implemented by a team at Cancer Treatment Options and Management Inc (CTOAM). Using Norgen’s plasma/serum workflow, CTOAM has utilized plasma as a liquid biopsy sample type for identifying cancer in undiagnosed patients, monitoring the efficiency of cancer treatment, and identifying patients in remission or with early recurrence. For this purpose, CTOAM has created 100’s of custom TaqMan probes that are used to monitor cancer patients.