Nat. Rev. Clin. Oncol. doi: /nrclinonc

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Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2017.14 Figure 1 Liquid biopsies capture the molecular heterogeneity of metastatic cancers Figure 1 | Liquid biopsies capture the molecular heterogeneity of metastatic cancers. Liquid biopsies of tumour components in the blood, including circulating cell-free tumour DNA (ctDNA) and RNAs (ctRNA), exosomes, and circulating tumour cells (CTCs), can be leveraged to capture the molecular heterogeneity of distinct tumour lesions harbouring different genetic alterations. The tables illustrate the detection of point mutations in oncogenes (G12D, G12C, and G13D mutations in KRAS; V600E mutation of BRAF; and K57N mutation of MAP2K1 (MEK1)) through candidate-gene or next-generation sequencing analysis of ctDNA in plasma. Identification of a LMNA–NTRK gene fusion is depicted in the sequence alignment. Gene copy-number variations can also be detected using fluorescence in situ hybridization analysis of CTCs isolated from the blood, as shown in the fluorescence micrograph, and via whole-exome analysis of blood-derived tumour DNA by next-generation sequencing (as demonstrated for FLT3 and ERBB2 (HER2) amplification). Siravegna, G. et al. (2017) Integrating liquid biopsies into the management of cancer Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2017.14