Circulating tumor DNA detection in hepatocellular carcinoma

Circulating tumor DNA (ctDNA) analysis has demonstrated excellent specificity and satisfactory sensitivity to detect somatic mutations across many tumor types and particularly in patients with metastatic disease [1, 2]. ctDNA detection rate and level primarily depend on tumor burden, proliferation and tumor type [3]. Its clinical use as a theragnostic biomarker for detecting EGFR mutation has been approved in stage IV non-small-cell lung cancer patients, in whom invasive tumor biopsy may be perilous because of limited accessibility and/or pre-existing organ dysfunction (e.g.