Cell-free DNA (cfDNA) is evolving into a widely used prognostic and predictive biomarker, particularly in oncology. However, its versatile clinical use precedes a profound understanding of the underlying biology of cfDNA release. There is much evidence to suggest that cfDNA is mainly derived from dying (i.e., apoptotic) cells. However, numerous cancer studies have shown that cfDNA is informative about acquired resistance to given therapies, which is present in living, proliferating tumor subclones. To explain this contradiction, we review current insights regarding cfDNA release, in particular the interplay between apoptosis and proliferation. We describe how improved knowledge about cfDNA biology could be used for novel therapeutic strategies and how this may affect patient management.

中文翻译：

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无细胞的DNA和细胞凋亡：死细胞如何通知生物。

无细胞DNA（cfDNA）正在发展成为一种广泛使用的预后和预测生物标志物，尤其是在肿瘤学中。然而，其广泛的临床应用先于对cfDNA释放的潜在生物学的深刻理解。有许多证据表明，cfDNA主要来源于垂死的（即凋亡的）细胞。然而，大量的癌症研究表明，cfDNA对于活体，增殖性肿瘤亚克隆中存在的对给定疗法的获得性耐药具有丰富的信息。为了解释这种矛盾，我们回顾了有关cfDNA释放的最新见解，特别是凋亡与增殖之间的相互作用。我们描述了如何将有关cfDNA生物学的改进知识用于新的治疗策略，以及这如何影响患者管理。