Liquid Biopsy Shows Promise for Monitoring Childhood Brain Tumors

Excerpt:

“New research by investigators at the University of California, San Francisco and the Children’s National Health System, has provided early evidence that liquid biopsy testing could help doctors monitor how well treatments are working in kids with diffuse midline gliomas.

“Brain cancers present a challenge for longitudinal monitoring, because obtaining repeat biopsy samples is dangerous and difficult. But liquid biopsy techniques have now opened the possibility of tracking these and other tumors over time based on analysis of tumor genetic material that is shed into the blood or other body fluids.”

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Liquid Biopsy IDs More NSCLC Mutations, Yields Patient Therapy Response in Study of Guardant Test

Excerpt:

“New data this week has added evidence for the value of blood-based cancer testing in non-small cell lung cancer, demonstrating in a cohort of about 300 that comprehensive liquid biopsy — in this case Guardant Health’s Guardant360 test — can help identify targeted mutations in more patients than tissue sequencing.

“The study also found that patients treated on the basis of blood-based test results respond to treatment similarly to those treated based on tissue test results.”

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DNA Mutations Shed in Blood Predicts Response to Immunotherapy in Patients With Cancer

Excerpt:

“In a first-of-its-kind study, University of California San Diego School of Medicine researchers report that a blood sample, or liquid biopsy, can reveal which patients will respond to checkpoint inhibitor-based immunotherapies.

” ‘We can help predict response to immunotherapy by measuring the number of mutations in circulating tumor DNA using a simple blood test,’ said Yulian Khagi, MD, UC San Diego Moores Cancer Center fellow and first author. ‘Immunotherapy can result in serious side effects, and therefore being able to predict who will respond is important to mitigating potential risk to each patient.’ ”

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Blood Test Instead of Biopsy for Metastatic Prostate Cancer

Excerpt:

“There has been a lot of buzz recently about the use of ‘liquid biopsies’ and how these blood tests that show cancer may be able to replace the need for tissue biopsies.

“The latest study shows that such a test could be useful in metastatic prostate cancer, where the biopsy sample would need to be taken from bone, which is painful, risky, and expensive, says an expert.

“This study used the Guardant360 test and found that cell-free, circulating tumor DNA (ctDNA) was detected in most patients (94%) with metastatic castration-resistant prostate cancer (mCRPC).”

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Testing for Tumor Mutations: Liquid Biopsy Versus Traditional Biopsy


Liquid biopsies, virtually unknown even a year or two ago, are becoming common tools in precision diagnostics for cancer. Here, I will try to explain some of the more important differences between liquid and “traditional” tumor biopsies.

Biopsies of solid tumors (e.g., lung, breast, or brain tumors) involve surgically removing a small part of a tumor and sending it to pathology lab. In the last few years, doctors have also started to send some tumor samples to special service labs that analyze tumor DNA for the presence of cancer-related mutations.

By definition, regular biopsies can be intrusive and are sometimes associated with side effects, such as bleeding or infection. However, they provide some really essential information; i.e., the histology and grade of the tumor and other tumor characteristics necessary to determine the best choice of treatment. For lung cancer, for example, a biopsy determines the type of tumor—adenocarcinoma, squamous cancer, small-cell lung cancer, or another, less common type. For breast cancer, a routine test will determine if the tumor expresses estrogen, progesterone receptors, and a protein called HER2. These tests are critically important in guiding treatment choices. If mutational analysis of cancer-related genes is also performed (which doesn’t always happen, unfortunately), it may guide treatment with targeted drugs. Continue reading…


One Patient, Two Cancer DNA Tests, Two Different Results

Excerpt:

“A couple years ago, Sibel Blau, an oncologist outside of Seattle, was working with the company Guardant Health to test their novel ‘liquid biopsies’ in patients. The idea behind liquid biopsies is both elegant and promising. A doctor takes a blood sample from a patient, and then Guardant looks for tumor DNA floating in the blood, allowing doctors to identify the tumor’s unique mutations and offer a personalized drug regimen—all without an invasive tissue biopsy. Blau was excited to be on board.

“When that study wrapped up, Blau still had Guardant test kits left over, so she offered some to her patients at no cost to them. At this point, Blau was routinely ordering DNA sequencing of traditional tissue biopsies, so some patients got both tests. The tissue DNA test from Foundation Medicine was “routine” in her practice, but even that test had only become available in 2012. The field of cancer DNA has been changing fast.”

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Case for Liquid Biopsies Builds in Advanced Lung Cancer

Excerpt:

“For patients with advanced lung cancer, a non-invasive liquid biopsy may be a more effective and suitable alternative to the gold standard tissue biopsy to detect clinically relevant mutations and help guide their course of treatment, suggests a new study published this week in the journal Clinical Cancer Research from researchers at the Abramson Cancer Center at the University of Pennsylvania(ACC).

“In patients with advanced non-small cell lung cancer (NSCLC) treated at Penn’s ACC, mutations detected from liquid biopsies (cell-free circulating tumor DNA (ctDNA) captured from blood) closely paralleled the mutations from tissue biopsies identified in next generation sequencing tests: EGRF, TP53, and ALK, to name a few. What’s more, in several cases, liquid biopsies captured clinically relevant mutations not found in tissue biopsies as patients’ disease progressed.”

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Liquid Biopsies for Identification of EGFR Mutations and Prediction of Recurrence

Excerpt:

“Three manuscripts published in the recent issue of the Journal of Thoracic Oncology, the official journal of the International Association for the Study of Lung Cancer (IASLC), explored the versatility of liquid biopsies by identifying EGFR mutations using circulating tumor DNA (ctDNA) in urine and plasma and examining circulating tumor cells (CTCs) in plasma to predict the risk of lung cancer recurrence after surgical resection. Collectively, these findings illustrate the potential and reach of liquid biopsies in both identifying patients suitable for targeted treatment as well as predicting cancer recurrence.

“Lung cancer is the most common type of cancer with the highest cancer-related mortality worldwide. Non-small cell lung cancer (NSCLC) accounts for roughly 85% of lung cancer and most patients present with advanced disease at diagnosis. Surgical resection is the preferred treatment option for patients with medically operable tumors. However, disease recurrence occurs in approximately 50% of cases. Patients with advanced disease are often not candidates for surgical resection and commonly harbor driver mutations that can be targeted by drugs. A major challenge for assessing driver mutations, such as epidermal growth factor receptor (EGFR) mutations, in advanced disease is the scarcity of suitable biopsy tissue for molecular testing. A minimally invasive alternative to invasive tissue biopsy is the use of liquid biopsy, which analyzes ctDNA or CTCs in a liquid biological sample (i.e. urine, blood, or serum).”

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Lung Cancer Highlights from ASCO 2016


This year, the Annual Meeting of the American Society of Clinical Oncology (ASCO) did not produce any truly groundbreaking revelations about new treatments for lung cancer. However, researchers did report quite a few positive findings, and some disappointing ones. I have summarized some of the more prominent presentations below. Continue reading…