The detection of circulating tumor DNA (ctDNA) has been studied over 30 years as a method to monitor response to antiproliferative therapies in oncologic patients and, recently, to identify somatic genomic alterations. However the investigated techniques have shown limits of sensitivity, high costs, the necessity for a patient-specific optimization and a narrow-spectrum applicability. The newest methods, in the preliminary reports, seem to go beyond these restraints. Therefore they could be routinely used in the clinical practice to observe and predict the response to chemoradiotherapy, surgery, and to orient the therapeutic choice. Nonetheless the most promising application of the ctDNA detection regards the screening programmes.
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