Liquid Biopsy Techniques Test Lung Cancer MRD Level

EP: 1.Timing of MRD Testing in Lung Cancer Affects Patient Outcomes

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EP: 2.Liquid Biopsy Techniques Test Lung Cancer MRD Level

EP: 3.Options for MRD Testing Affect Patient Treatment Plan in Lung Cancer

Luis E. Raez, MD, medical director and chief scientific officer at Memorial Cancer Institute in Pembroke Pines, Florida, discusses the current liquid biopsy options for patients with lung cancer through assessing circulating tumor DNA (ctDNA).

These choices include identifying tumor-specific clones with tumor genotype-informed tests, such as Signatera, or detecting ctDNA in the blood with tumor genotype-uninformed tests. Raez highlights the debate between these 2 approaches, noting that tumor-informed biopsies are personalized and follow the tumor's evolution, while tumor-uninformed ctDNA detection only indicates cancer recurrence and is not patient specific.

Currently, Signatera is awaiting approval from the FDA as a molecular residual disease (MRD) test generally, but there are many ongoing studies using Signatera, emphasizing the potential benefits for patients. However, there is frustration for both patients and physicians when unable to determine if a patient will need additional systemic therapy post-surgery, according to Raez, underscoring the importance of accurate posttreatment assessments.

TRANSCRIPTION:

0:10 | We have 2 options now in liquid biopsies. One is to do tumor informed, meaning Signatera; we go to the tissue, and we identify among 16 different clones, which one or which ones the patient has, and we look for these tumor-specific clones. That's what we call them tumor informed. The other option, the other technologies that we use now, is only ctDNA. If we find ctDNA in your blood, it's because there is a recurrence. If there is no ctDNA in your blood, you are doing well, but that's tumor uninformed. So now we have the debate between which one of these technologies is better. Signatera looks very rational because you want to follow what your tumor has, and it's personalized because we do it patient by patient. So that's why—we will see, I guess. For lung cancer, that's what we do.

1:04 | We are waiting for FDA approval for MRD. To be fair, there are other MRD options, but this is something [where]...there is more than 80 or 90 studies ongoing with Signatera. That is why we're very excited that we may get some indications and validation and benefit for the patients. That's the most important thing because, as I said, if you have 100 patients with lung cancer, breast cancer, [etc], and after surgery, not knowing who is cured and who is not is something very frustrating—not only for the patients, but also for the doctors because we have to put them on treatment that they may not need.