Serial Liquid Biopsies May Predict Response to Colon Cancer Treatment Interview with:

Andrea Sottoriva, PhD, MSc Reader in Cancer Evolutionary Dynamics | Evolutionary Genomics & Modelling Lab Centre for Evolution and Cancer | The Institute of Cancer Research London

Dr. Sottoriva

Dr. Andrea Sottoriva, PhD
Centre for Evolution and Cancer, The Institute of Cancer Research, London, United Kingdom What is the background for this study?
Would you briefly explain what is meant by a liquid biopsy?

Cetuximab is a targeted treatment available for metastatic colorectal cancer patients. Unfortunately, although many patients benefit from Cetuximab, after an initial response to the treatment many patients relapse and become resistant to the drug.

We know that this resistance is due to the tumour evolving and adapting to therapy. Liquid biopsies allow to look for residual cancer DNA in the blood of a patient and hence monitor the emergence of resistance over time. We used blood samples take every 4 weeks (quite frequently for this type of study) to monitor the evolution of the cancers under treatment and see if there were some measurements that would predict if and when patients will relapse. What are the main findings?

Response: We found that patients who had residual cancer DNA in their blood at the start of treatment unfortunately would not benefit from Cetuximab at all. We also were able, for those patients that did respond initially, to combine the blood genetic data with mathematical modelling and, a bit like weather forecasting, predict when a patient would relapse. These predictions are fundamental for doctors to intervene early and stay one step ahead of the cancer. What should readers take away from your report?

Response: This study demonstrate that it is possible, using the right monitoring approaches, to make quantitative predictions about future course of cancer in individual patients, a key advance for the implementation of personalised medicine. A bit like in the game of chess, the key to treat cancer, a disease that changes over time and adapts to treatment, is staying one move ahead of the opponent. What recommendations do you have for future research as a result of this work? 

Response: These are early results that will need to be confirmed in larger studies. However, our study opens the door for novel research on cancer forecasting as well as potentially new types of clinical trials where frequent liquid biopsies are used to closely monitor cancer patients under treatment. 


Longitudinal Liquid Biopsy and Mathematical Modeling of Clonal Evolution Forecast Time to Treatment Failure in the PROSPECT-C Phase II Colorectal Cancer Clinical Trial
August 30, 2018
doi: 10.1158/2159-8290.CD-17-0891

Oct 30, 2018 @ 1:59 pm

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