Circulating tumor DNA (ctDNA) is moving out of the lab and into breast cancer clinics around the globe. Liquid biopsies using tumor DNA extracted from plasma have become standard of care in metastatic breast cancer and are potentially on the way to finding utility in earlier stage disease.
“You are seeing liquid biopsies in the latest guidelines from the National Comprehensive Cancer Network, the European Society for Medical Oncology, and other groups,” said Nicholas Turner, MD, PhD, Consultant Oncologist and Professor, Institute of Cancer Research and The Royal Marsden Hospital, London, UK. “Circulating tumor DNA is helping define which patients have mutations that you can select drugs for, and can be used in, routine clinical practice provided the limitations of liquid biopsies are understood.”
Dr. Turner will moderate What ctDNA Can Tell Us on Thursday, December 8, from 3:00 – 5:00 pm CT in Stars at Night Ballroom 3&4. Look for an update on the current uses of liquid biopsies in metastatic disease as well as growing applications for ctDNA in clinical trials. The one setting in which ctDNA does not have a current clinical role is an early-stage disease. But that could change.
“Blood tests can accurately predict recurrence in early breast cancer, although it’s not been shown that you can use that information to improve outcome,” Dr. Turner said. “There are trials under way in the early breast cancer setting, but it’s not yet standard of care.”
Nor is there a single accepted approach for ctDNA. Heather Parsons, MD, MPH, Assistant Professor of Medicine, Harvard Medical School and medical oncologist at the Susan F. Smith Center for Women’s Cancers, Dana-Farber Cancer Institute, will discuss the pros and cons of multiple techniques currently being used to collect and assess liquid biopsies.
Ben O’Leary, MBBS, PhD, Clinician Scientist, Institute of Cancer Research and The Royal Marsden Hospital, London, UK, will discuss persistent questions surrounding the utility of liquid biopsies compared to more familiar tissue testing in the research setting. Both approaches are intended to assess response to treatment, but the techniques, logistics, costs, and acceptance of results may or may not be the same.
“Liquid biopsies give us a way to monitor the cancer genome as it changes with treatment, more effectively and get very rapid assessments of whether a tumor is responding to treatment or not,” Dr. Turner said. “The real question is whether liquid biopsies for these potential monitoring indications can translate to clinical practice and what that switch might mean for researchers, clinical trials, and patients in those trials.”
Minetta C. Liu, MD, Co-Director, Genomics in Action Program, Mayo Clinic Center for Individualized Medicine and Research Chair of Oncology will discuss the continuing evolution of liquid biopsies in early-stage breast cancer. She is involved in the development and validation of multiple platforms for isolating and analyzing both ctDNA and cell-free DNA liquid biopsies.
“We have seen rapid developments in the ways clinicians and researchers can use liquid biopsies in daily practice,” Dr. Turner said. “This session will give you a practical look at how to best use liquid biopsies today and some of the ways we might be able to use them in the future in the adjuvant setting to individualize patient therapy.”