Emerging Biosensor Technologies for Multiplex Detection of Breast Cancer Biomarkers: From Nanomaterials to Clinical Translation

Abstract

Breast cancer is the most prevalent type of cancer among females across the globe and early detection, and accurate diagnosis of the biomarkers are crucial to improve the prognosis of the patient. Despite their proven value, traditional immunoassay based diagnostics platforms are not particularly sensitive, not multiplexable, and are not ideal for point of care applications. This review deals with the advanced biosensor technologies developed for the multiplex detection of breast cancer-related, important biomarkers like human epidermal growth factor receptor 2 (HER2), cancer antigen 15-3 or CA 15-3 (CA153), carcinoembryonic antigen (CEA), mutations in the BRCA1/2 genes and circulating tumor DNA (ctDNA). The electrochemical, optical, piezoelectric, and microfluidic biosensor modalities are studied with the aim of using novel nano materials such as gold nanoparticles, graphene oxide, carbon nanotubes, and metal-organic frameworks (MOFs). Signal amplification strategies, surface functionalization of chemistries, and using machine learning for data interpretation are highlighted. Clinical translation was discussed as an important topic for which biocompatibility, regulatory aspects (FDA, CE-IVD) and real time validation in patient serum are important points. Other areas of emerging interest like biosensors with CRISPR technology, wearable biosensors, and AI-assisted diagnostic pipelines also feature. The aim of this review is to provide a logical approach to designing novel multiplex biosensors for the revolution in breast cancer diagnostics.