A Comprehensive Review on The Value of Circulating Tumor DNA in Biliary Tract Cancer: Enhancing Cancer Management and Predicting Patient Outcomes

Circulating Tumor Cells (CTCs) refer to malignant cells that have separated from the main tumor and disseminated throughout the circulation. Circulating tumor DNA is specifically derived from the tumor and discharged into the bloodstream. Nowadays, scientists are devising instruments and methodologies to capture and detect these malignant cells more precisely and delicately from the blood of individuals with cancer, through the implementation of both physical and immunoaffinity-based methodologies, as well as positive and negative enrichment approaches all through separation. BTC encompasses a wide range of malignant neoplasms that are typically classified according to their anatomic location, including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, gallbladder cancer, and cancer of the ampulla of Vater. Biliary Tract Cancer (BTC) is a malignant tumor that displays a high degree of ferocity and carries an unfavorable outcome. BTCs are the second most frequent type after Hepatocellular Carcinoma (HCC). Despite the challenges posed by BTC, there have been significant advances in identifying genetic mutations that can be targeted in affected patients. These breakthroughs have led to the creation of novel targeted therapies, with promising results in recent studies. Utilizing liquid biopsy, a non-intrusive technique for detecting tumor biomarkers from samples can provide valuable assistance in diagnosing and molecularly characterizing the tumor. Liquid biopsy has garnered mounting interest as a potential instrument for the diagnosis and treatment of cancer in recent times. The utilization of ctDNA analysis has the capability of providing timely identification of oncogenic mutations, timely detection, treatment surveillance, and identification of treatment resistance pathways in cancer management. This article presents a comprehensive review of the existing literature on the use of ctDNA in patients with BTC, with an emphasis on the latest innovative methodologies and future prospects for managing this extremely malignant disorder.