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Technological advances, in particular the development of high-throughput sequencing, have led to the emergence of a new generation of molecular biomarkers for tumors. These new tools have profoundly changed therapeutic management in oncology, with increasingly precise molecular characterization of tumors leading to increasingly personalized therapeutic targeting. Detection of circulating tumor cells and/or circulating tumor DNA in blood samples -so-called 'liquid biopsies'- can now provide a genetic snapshot of the patient's tumor through an alternative and less invasive procedure than biopsy of the tumor tissue itself. This procedure for characterizing and monitoring the disease in real time facilitates the search for possible relapses, the emergence of resistance, or emergence of a new therapeutic target. In the long term, it might also provide a means of early detection of cancer. These new approaches require the treatment of ever-increasing amounts of clinical data, notably, with the goal of calculating composite clinical-biological predictive scores. The use of artificial intelligence will be unavoidable in this domain, but it raises ethical questions and implications for the health-care system that will have to be addressed., Les progrès technologiques, en particulier le développement du séquençage à haut débit, ont conduit à l’émergence d’une nouvelle génération de biomarqueurs tumoraux moléculaires. Ces nouveaux outils ont profondément modifié la prise en charge thérapeutique en oncologie avec une caractérisation moléculaire de plus en plus précise des tumeurs amenant à un ciblage thérapeutique personnalisé. La détection des cellules tumorales circulantes et/ou de l’ADN tumoral circulant dans des prélèvements sanguins, encore appelés « biopsies liquides », peut désormais fournir un instantané du profil génétique de la tumeur du patient grâce à une procédure alternative et moins invasive qu’une biopsie du tissu tumoral lui-même. Cette méthode de caractérisation moléculaire et de suivi de la maladie en temps réel facilite la recherche d’éventuelles rechutes, de l’émergence de résistances ou d’une nouvelle cible thérapeutique. À long terme, les biopsies liquides pourraient également fournir un moyen de détection précoce du cancer. Ces nouvelles approches nécessitent le traitement d’une quantité, toujours croissante, de données, en particulier cliniques, notamment dans l’optique d’élaborer des scores clinico-biologiques composites. L’utilisation de l’intelligence artificielle est un outil d’avenir dans ce domaine, mais elle soulève des questions éthiques et des implications pour l’organisation du système de santé qui devront être abordées.

In oncology, the identification of targets that correlate with a type of cancer has led to a profound change in the notion of "tumor markers". Technological advances, in particular the development of high-throughput sequencing, have led to the emergence of a new generation of molecular biomarkers for tumors. Despite their limited utility for screening and diagnosis, conventional tumor markers remain interesting for evaluation of prognoses, the choice and optimization of treatments, as well as for monitoring the effectiveness of those treatments. In this article, we revisit the conventional serum markers that are enjoying a 'come back' thanks to the development of high-performance scores based on biological, cytological, clinical, or radiological criteria.

Ovarian yolk sac tumour (OYST) is a very rare malignancy arising most often in young women. Preoperative clinical, biological (alpha-foetoprotein) and radiological findings should help to establish the diagnosis of OYST, in order to propose adequate surgical treatment. The aim of surgery is to remove the primary tumour, to obtain an accurate histological diagnosis and to assess the disease extent. In young women, fertility-sparing surgery should be performed, in order to preserve the possibility of pregnancy later on. Chemotherapy has substantially modified the prognosis of these tumours, and practically all patients will be cured. The overall 5-year survival rate is 94% when patients are treated with BEP chemotherapy. Depending on the clinical situation, two to four cycles of the BEP regimen should be administered after surgery. Identification of prognostic factors may help to propose risk-adapted treatment in order to increase the cure rate in patients with a poor prognosis and to decrease toxicity in patients with a low risk of relapse. Fertility preservation represents a major objective in women treated for OYSTs.