Impact of liquid biopsy on health-related quality of life in cancer treatment: A systematic review.

Abstract

e14538 Background: Liquid biopsy has emerged as a promising tool in cancer management, offering non-invasive methods for monitoring disease progression and guiding treatment decisions. Health-related quality of life (HR-QOL) is a crucial aspect of cancer care, reflecting the impact of treatment on patients' physical and emotional well-being. This review explores the role of liquid biopsy, particularly circulating tumor DNA (ctDNA) and circulating tumor cells (CTC) analysis, in improving HR-QOL outcomes for cancer patients. Methods: A comprehensive literature search was conducted following PRISMA guidelines on PubMed, Cochrane Library, Embase, and ClinicalTrials.gov using the keywords "liquid biopsy," "ctDNA," "HR-QOL," and "cancers." From a total of 1508 reports, two abstracts, and one full-text article were selected based on their focus on the impact of liquid biopsy on quality of life. The selected studies were systematically reviewed and described. Results: This systematic review evaluated 2250 patients across three studies: BESPOKE CRC (Kasi et al., 2024), COMET (Pierga et al., 2023), and LIQUID IMPACT (Nagarkar et al., 2020). The BESPOKE CRC study (n = 1,792) focused on the clinical utility of ctDNA analysis in detecting recurrence and optimizing adjuvant chemotherapy for patients with surgically resected colorectal cancer (CRC). Results indicated that ctDNA testing significantly reduced anxiety about cancer recurrence in 62% of patients, with ctDNA-negative patients reporting lower anxiety compared to ctDNA-positive patients (average score 4.01 vs. 3.57, p < 0.0001). The COMET study (n = 432) investigated the relationship between circulating tumor cells (CTCs) and health-related quality of life (QoL) in patients with HER2-negative metastatic breast cancer receiving weekly paclitaxel and bevacizumab. Elevated baseline CTC counts were associated with a decline in emotional functioning (p = 0.0262), which worsened further with high CTC levels after one cycle of chemotherapy (p = 0.0137). In the LIQUID IMPACT study (n = 26), which examined multi-analyte liquid biopsy (MLB) profiling to guide personalized treatment in advanced cancers, 96% of patients reported stable to improved symptom status. In comparison, 46% reported stable to improved functional activities. Conclusions: These studies emphasize the role of liquid biopsy methods, such as ctDNA and CTC analysis, in enhancing quality of life during cancer treatment. By monitoring disease progression and informing treatment decisions, these methods help reduce anxiety and improve patient well-being. Further research is needed to confirm their impact on long-term quality of life across different cancer types.