Our recent webinar series, ‘Unlocking Precision Oncology’s Full Potential through Next-Gen Molecular Analysis’, showcased cutting-edge advances in diagnostics, molecular profiling and therapy resistance, revealing how adaptive strategies are reshaping cancer treatment and precision oncology.
Across three webinars, eight expert speakers explored various aspects of precision oncology, including next-generation molecular analysis technologies, personalised treatment approaches, the promise of liquid biopsy and ctDNA testing, resistance mechanisms, and the challenges of implementation.
In part two of this series, we summarise the promise of liquid biopsy and ctDNA analysis, which was highlighted throughout the talks.
The promise of liquid biopsy
In webinar 1 of this series, speakers Umberto Mallapelle, Sanjay Popat and Eric Christenson explored the potential of liquid biopsy and ctDNA testing in precision cancer care. The key areas for opportunity highlighted were:
Faster diagnosis: ctDNA can provide molecular insights much quicker than traditional tissue biopsy, reducing wait times for treatment decisions and ultimately giving patients a better chance of survival.
Improved patient selection: ctDNA analysis can help to identify patients who might benefit from targeted therapies, especially in lung and colorectal cancers. This could not only help to improve survival rates, but also to minimise side effects and increase quality of life by proving the most appropriate treatments.
Complement tissue testing: ctDNA can detect mutations that might be missed in tissue samples due to inadequate tissue or tumor heterogeneity. It can also help test patients who might otherwise be difficult to biopsy or have insufficient tissue for traditional testing. However, tissue biopsy still has an important place in cancer diagnostics, and the two techniques should complement each other.
Minimal residual disease monitoring: Liquid biopsy and ctDNA analysis can help track cancer recurrence and guide adjuvant treatment decisions in early-stage cancers. This, again, could improve outcomes for patients who are at risk of disease recurrence, allowing them to obtain treatment sooner.
Treatment resistance tracking: In metastatic settings, ctDNA can detect emerging resistance mutations and help guide treatment changes.
Cost-effectiveness: The NHS pilot described by Sanjay Popat showed potential cost savings of around £53 million by avoiding additional diagnostic procedures and getting patients on the right treatment faster.
Speakers from webinars 2 and 3 also highlighted that liquid biopsy and ctDNA testing could be presented as a complementary technique to tissue biopsy, especially in light of the fact that a significant number of tissue biopsies are not suitable for testing.
The challenges
As with all new techniques, the implementation of liquid biopsy and ctDNA has its challenges Here, we summarise the insights from our speakers.
Sensitivity and detection limits: ctDNA can be present in very low quantities, making it difficult to detect and analyse accurately in some patients This further supports the idea of ctDNA testing and tissue biopsy as complementary techniques.
Pre-analytical variability: Blood collection, processing and storage can significantly impact the quality and quantity of ctDNA.
Tumour heterogeneity: Not all tumour mutations may be shed into the bloodstream, potentially leading to false negatives.
Technical limitations: Different ctDNA platforms have varying capabilities in detecting mutations and genomic alterations.
Cost and accessibility: Advanced ctDNA testing can be expensive, meaning not all healthcare systems can or will incorporate this method, and not all patients will be able to access it.
Interpretation complexity: Distinguishing between clinically significant mutations and background “noise” requires sophisticated analysis.
Limited tissue of origin information: ctDNA alone may not always provide clear insights into the specific type or location of a tumour.
Check back next week, where we’ll discuss resistance mechanisms and how precision oncology can overcome them.
With thanks to the speakers from the Unlocking Precision Oncology’s Full Potential through Next-Gen Molecular Analysis webinar series.
