08 Apr Carefully Chosen Liquid Biopsy Can Detect and Monitor Lung Cancer Mutations
MedicalResearch.com Interview with:
Adrian G. Sacher, M.D.
Assistant Professor of Medicine
Thoracic Oncology & Phase I Drug Development
Columbia University/New York-Presbyterian Hospital
MedicalResearch.com: What is the background for this study?
Dr. Sacher: The aim of this prospective study was to determine the accuracy, turnaround time and robustness of ddPCR-based liquid biopsy for the detection of EGFR and KRAS mutations in patients with advanced non-small cell lung cancer (NSCLC). The detection of these mutations is key to selecting optimal therapy for patients with this disease. Currently, the standard of care is to perform tissue biopsies on patients in order to obtain material to detect these mutations and make decisions about treatment. Frequently, patients undergo multiple tissue biopsies during the course of their treatment. We sought to determine if liquid biopsy could quickly and accurately detect these mutations with the ultimate goal of understanding how to use these tests to select treatment for patients.
MedicalResearch.com: What are the main findings?
Dr. Sacher: We studied 180 patients with advanced non-small cell lung cancer and found that our ddPCR-based liquid biopsy was able to detect EGFR and KRAS mutations with perfect specificity (100%) and high sensitivity (69-80%). The specificity of this assay is lower for the detection of the EGFR T790M resistance mutation (63%) which we suspect is secondary to tumor heterogeneity of resistance producing false-negative tissue genotyping results. Importantly, the turnaround time for liquid biopsy was 2-3 days compared to multiple weeks for standard tissue genotyping.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Sacher: This is the first prospective study of liquid biopsy in advanced NSCLC. We have demonstrated in this carefully designed prospective study that clinicians can trust the results of this assay when targetable mutations are detected and use this data for clinical decisions. However, if a liquid biopsy detects no mutant tumor DNA then standard genotyping of a tissue biopsy is needed to confirm this result.
Importantly, not all liquid biopsy assays are the same and caution should be exercised when generalizing the results of this study to other platforms. This study can only comment on the test characteristics of the specific ddPCR-based liquid biopsy assay that we have developed.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Sacher: One of the most exciting future areas of research to come out of this study is the potential to use liquid biopsy to monitor for response to treatment. We found in this study that liquid biopsy can not only detect mutant tumor DNA in the blood but also monitor how the concentration of tumor DNA changes in response to treatment. We are actively investigating the ability of this technology to monitor both whether a patient is responding to treatment as well as the fashion in which a patient’s tumor is changing genetically and potentially becoming resistant to treatment in real-time.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Sacher: I would like to thank the patients and their families that participated in this study. They face a challenging illness everyday with dignity and strength. Through this study they have helped us to improve cancer treatment for patients everywhere.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Adrian G. Sacher, MD; Cloud Paweletz, PhD; Suzanne E. Dahlberg, PhD; Ryan S. Alden, BSc; Allison O’Connell, BSc; Nora Feeney, BSc; Stacy L. Mach, BA; Pasi A. Jänne, MD, PhD; Geoffrey R. Oxnard, MD. Prospective Validation of Rapid Plasma Genotyping for the Detection of EGFR and KRAS Mutations in Advanced Lung Cancer. JAMA Oncology, April 2016 DOI: 10.1001/jamaoncol.2016.0173
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Dr. Adrian Sacher (2016). Carefully Chosen Liquid Biopsy Can Detect and Monitor Lung Cancer Mutations MedicalResearch.com