Noninvasive precision diagnosis and real-time monitoring for oral cancer based on patient’s time axis

Abstract

To date, “precision medicine” in cancer treatment has involved stratifying patients by genetic characterization and providing proper drugs. In Japan, oncopanel gene analysis is covered by medical insurance, however, the driver genes are usually not amenable to drugs. Thus, it is difficult to apply the benefits of precision medicine to the public’s health. Another problem is “cancer plasticity” in which the genetic profile of cancer cells continuously changes over time during treatment such as surgery and chemoradiation. This means that real-time diagnosis and sampling should be established.
We have focused on real-time sampling, diagnosis and monitoring according to the time of cancer and have developed a non-invasive precision diagnosis for oral cancer. This review outlines the precision diagnosis methods for 1） super-early detection of oral potentially malignant diseases （OPMDs） and SCC, 2） diagnosis of existence of oral cancer and metastasis using serum micro RNA and 3） isolation of circulation tumor cells （CTCs） and possibility of their utilization in precision diagnosis and treatment.