Table 2.

Summary of most relevant studies with liquid biopsy in patients with MB.

Author (year)NReservoirNo. of samplesSequencing methodGenomic studiesDetection rateOther findings and potential applications
Escudero et al. (2020) [11]13CSF and PlasmaSerialTumor: NGS
CSF: NGS and ddPCR
Plasma: ddPCR
WESCSF: 10/13 (76.9%) (baseline)
Plasma: 1/13 (7.7%)
CSF ctDNA reflects tumor genomic alterations and evolution, allows MB subgroup classification, and identifies MRD
Li et al. (2020) [12]3CSFSerialWGBS and CMS-IP-SeqWGMeth (WGBS and CMS-IP-Seq)ctDNA WGMeth precedes positive cytology and identifies markers with predictive and prognostic value
Liu et al. (2021) [13]123CSFSerialNGSWGSMRD: 67/105 (64%)
MRD SHH vs WNT vs G3 vs G4: 32% vs 63% vs 77% vs 75%
Metastatic: 29/34 (85%)
Non-metastatic: 38/71 (54%)
High concordance tumor-CSF
MRD detection preceded relapse by ≥3 m
Sun et al. (2021) [14]58CSF: 58
Plasma: 6
SingleNGSWES15/58 (26%)ctDNA-positive CSF associated with worse prognosis
Lee et al. (2022) [15]40CSFSingleRNA-seq and HRMSRNA-seq and HRMSDifferent transcriptomic profile, cirRNA and metabolic profiles in CSF between pts with MB and pts without MB
Pagès et al. (2022) [16]258CSF
Plasma
SingleULP-WGSULP-WGSCSF CNA: 9/46 (20%)
CSF alterations: 3/10 (30%)
Plasma CNA: 3/230 (1.3%)
Plasma alterations: 2/74 (2.7%)
CSF is more reliable than plasma for genomic analyses in children with MB
Arthur et al. (2023) [17]12CSF and PlasmaSerialTumor: NGS
CSF: ddPCR
SNCAIP, CTNNB1, PIK3CA, FOSL2, ZNF536, HEXB, MAX, PTCH1, B4GALT1, KDM5D, CDK6, SAMD8, PRMT7, KMT2D, OFD1, SMO, KDM6ACSF: 7/12
Plasma: 4/9
CSF ctDNA positive in tumors growing into a CSF reservoir
Current study1PlasmaSerialdPCRPTCH1 Y873*10/18 timepoints positive
8/8 false negative
ctDNA PTCH1 mutation dynamics mirrored accurately radiological response
Author (year)NReservoirNo. of samplesSequencing methodGenomic studiesDetection rateOther findings and potential applications
Escudero et al. (2020) [11]13CSF and PlasmaSerialTumor: NGS
CSF: NGS and ddPCR
Plasma: ddPCR
WESCSF: 10/13 (76.9%) (baseline)
Plasma: 1/13 (7.7%)
CSF ctDNA reflects tumor genomic alterations and evolution, allows MB subgroup classification, and identifies MRD
Li et al. (2020) [12]3CSFSerialWGBS and CMS-IP-SeqWGMeth (WGBS and CMS-IP-Seq)ctDNA WGMeth precedes positive cytology and identifies markers with predictive and prognostic value
Liu et al. (2021) [13]123CSFSerialNGSWGSMRD: 67/105 (64%)
MRD SHH vs WNT vs G3 vs G4: 32% vs 63% vs 77% vs 75%
Metastatic: 29/34 (85%)
Non-metastatic: 38/71 (54%)
High concordance tumor-CSF
MRD detection preceded relapse by ≥3 m
Sun et al. (2021) [14]58CSF: 58
Plasma: 6
SingleNGSWES15/58 (26%)ctDNA-positive CSF associated with worse prognosis
Lee et al. (2022) [15]40CSFSingleRNA-seq and HRMSRNA-seq and HRMSDifferent transcriptomic profile, cirRNA and metabolic profiles in CSF between pts with MB and pts without MB
Pagès et al. (2022) [16]258CSF
Plasma
SingleULP-WGSULP-WGSCSF CNA: 9/46 (20%)
CSF alterations: 3/10 (30%)
Plasma CNA: 3/230 (1.3%)
Plasma alterations: 2/74 (2.7%)
CSF is more reliable than plasma for genomic analyses in children with MB
Arthur et al. (2023) [17]12CSF and PlasmaSerialTumor: NGS
CSF: ddPCR
SNCAIP, CTNNB1, PIK3CA, FOSL2, ZNF536, HEXB, MAX, PTCH1, B4GALT1, KDM5D, CDK6, SAMD8, PRMT7, KMT2D, OFD1, SMO, KDM6ACSF: 7/12
Plasma: 4/9
CSF ctDNA positive in tumors growing into a CSF reservoir
Current study1PlasmaSerialdPCRPTCH1 Y873*10/18 timepoints positive
8/8 false negative
ctDNA PTCH1 mutation dynamics mirrored accurately radiological response

Abbreviations: CNA: copy number alterations, CMS-IP-Seq: anti-cytosine-5-methylenesulfonate immunoprecipitation sequencing, CSF: cerebrospinal fluid, ctDNA: circulating tumor DNA, dPCR: digital PCR, ddPCR: droplet digital PCR, G3: group 3 MB, G4: group 4 MB, HRMS: high-resolution mass spectrometry, MB: medulloblastoma, MRD: minimal residual disease, NGS: next-generation sequencing, SHH: sonic hedgehog activated MB, ULP-WGS: ultra-low pass whole-genome sequencing, WES: whole-exome sequencing, WGMeth: whole-genome methylation, WGBS: whole-genome bisulfite sequencing, WGS: whole-genome sequencing, WNT: WNT-altered MB.

Table 2.

Summary of most relevant studies with liquid biopsy in patients with MB.

Author (year)NReservoirNo. of samplesSequencing methodGenomic studiesDetection rateOther findings and potential applications
Escudero et al. (2020) [11]13CSF and PlasmaSerialTumor: NGS
CSF: NGS and ddPCR
Plasma: ddPCR
WESCSF: 10/13 (76.9%) (baseline)
Plasma: 1/13 (7.7%)
CSF ctDNA reflects tumor genomic alterations and evolution, allows MB subgroup classification, and identifies MRD
Li et al. (2020) [12]3CSFSerialWGBS and CMS-IP-SeqWGMeth (WGBS and CMS-IP-Seq)ctDNA WGMeth precedes positive cytology and identifies markers with predictive and prognostic value
Liu et al. (2021) [13]123CSFSerialNGSWGSMRD: 67/105 (64%)
MRD SHH vs WNT vs G3 vs G4: 32% vs 63% vs 77% vs 75%
Metastatic: 29/34 (85%)
Non-metastatic: 38/71 (54%)
High concordance tumor-CSF
MRD detection preceded relapse by ≥3 m
Sun et al. (2021) [14]58CSF: 58
Plasma: 6
SingleNGSWES15/58 (26%)ctDNA-positive CSF associated with worse prognosis
Lee et al. (2022) [15]40CSFSingleRNA-seq and HRMSRNA-seq and HRMSDifferent transcriptomic profile, cirRNA and metabolic profiles in CSF between pts with MB and pts without MB
Pagès et al. (2022) [16]258CSF
Plasma
SingleULP-WGSULP-WGSCSF CNA: 9/46 (20%)
CSF alterations: 3/10 (30%)
Plasma CNA: 3/230 (1.3%)
Plasma alterations: 2/74 (2.7%)
CSF is more reliable than plasma for genomic analyses in children with MB
Arthur et al. (2023) [17]12CSF and PlasmaSerialTumor: NGS
CSF: ddPCR
SNCAIP, CTNNB1, PIK3CA, FOSL2, ZNF536, HEXB, MAX, PTCH1, B4GALT1, KDM5D, CDK6, SAMD8, PRMT7, KMT2D, OFD1, SMO, KDM6ACSF: 7/12
Plasma: 4/9
CSF ctDNA positive in tumors growing into a CSF reservoir
Current study1PlasmaSerialdPCRPTCH1 Y873*10/18 timepoints positive
8/8 false negative
ctDNA PTCH1 mutation dynamics mirrored accurately radiological response
Author (year)NReservoirNo. of samplesSequencing methodGenomic studiesDetection rateOther findings and potential applications
Escudero et al. (2020) [11]13CSF and PlasmaSerialTumor: NGS
CSF: NGS and ddPCR
Plasma: ddPCR
WESCSF: 10/13 (76.9%) (baseline)
Plasma: 1/13 (7.7%)
CSF ctDNA reflects tumor genomic alterations and evolution, allows MB subgroup classification, and identifies MRD
Li et al. (2020) [12]3CSFSerialWGBS and CMS-IP-SeqWGMeth (WGBS and CMS-IP-Seq)ctDNA WGMeth precedes positive cytology and identifies markers with predictive and prognostic value
Liu et al. (2021) [13]123CSFSerialNGSWGSMRD: 67/105 (64%)
MRD SHH vs WNT vs G3 vs G4: 32% vs 63% vs 77% vs 75%
Metastatic: 29/34 (85%)
Non-metastatic: 38/71 (54%)
High concordance tumor-CSF
MRD detection preceded relapse by ≥3 m
Sun et al. (2021) [14]58CSF: 58
Plasma: 6
SingleNGSWES15/58 (26%)ctDNA-positive CSF associated with worse prognosis
Lee et al. (2022) [15]40CSFSingleRNA-seq and HRMSRNA-seq and HRMSDifferent transcriptomic profile, cirRNA and metabolic profiles in CSF between pts with MB and pts without MB
Pagès et al. (2022) [16]258CSF
Plasma
SingleULP-WGSULP-WGSCSF CNA: 9/46 (20%)
CSF alterations: 3/10 (30%)
Plasma CNA: 3/230 (1.3%)
Plasma alterations: 2/74 (2.7%)
CSF is more reliable than plasma for genomic analyses in children with MB
Arthur et al. (2023) [17]12CSF and PlasmaSerialTumor: NGS
CSF: ddPCR
SNCAIP, CTNNB1, PIK3CA, FOSL2, ZNF536, HEXB, MAX, PTCH1, B4GALT1, KDM5D, CDK6, SAMD8, PRMT7, KMT2D, OFD1, SMO, KDM6ACSF: 7/12
Plasma: 4/9
CSF ctDNA positive in tumors growing into a CSF reservoir
Current study1PlasmaSerialdPCRPTCH1 Y873*10/18 timepoints positive
8/8 false negative
ctDNA PTCH1 mutation dynamics mirrored accurately radiological response

Abbreviations: CNA: copy number alterations, CMS-IP-Seq: anti-cytosine-5-methylenesulfonate immunoprecipitation sequencing, CSF: cerebrospinal fluid, ctDNA: circulating tumor DNA, dPCR: digital PCR, ddPCR: droplet digital PCR, G3: group 3 MB, G4: group 4 MB, HRMS: high-resolution mass spectrometry, MB: medulloblastoma, MRD: minimal residual disease, NGS: next-generation sequencing, SHH: sonic hedgehog activated MB, ULP-WGS: ultra-low pass whole-genome sequencing, WES: whole-exome sequencing, WGMeth: whole-genome methylation, WGBS: whole-genome bisulfite sequencing, WGS: whole-genome sequencing, WNT: WNT-altered MB.

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