Potential for Early Intervention in Relapsed SCLC Based on Liquid Biopsy

Gene G. Finley, MD, medical oncologist at Allegheny Clinic Medical Oncology of Allegheny Health Network (AHN), discusses the potential use of molecular testing to improve outcomes for patients with relapsed small cell lung cancer (SCLC).

Finley says that while there are not many known actionable biomarkers for SCLC, there is potential in using liquid biopsy to predict the chance of relapse, as is possible for patients with early-stage resected colon cancer. Circulating tumor DNA in the blood is being investigated as a predictor of relapse rather than waiting until radiographic evidence of relapsed disease to begin treatment.

This approach could benefit patients with limited-stage SCLC whose disease has not yet recurred, since SCLC has poor outcomes for patients who relapse. Treatment options for relapsed disease may be more effective if they are begun earlier.

Similar early intervention trials in SCLC would be valuable, according to Finley, and he says AHN is collecting patient biomarker data that could be used to find predictors of better or worse outcomes in SCLC and other cancer types.

TRANSCRIPTION:

0:08 | There’s not many well-defined biomarkers that are useful in the small cell space, unfortunately. What I do think has some legs is this idea of using a liquid biopsy as a strategy to predict patients [who] are destined for relapse and then providing an intervention there. We know in colorectal cancer, for example, in patients with early-stage resected disease, that you can utilize a liquid biopsy or bespoke assays to detect tumor-related DNA as it reappears in the blood. There are a number of intervention trials that are underway and many that have been completed showing that that does have benefit and that we would expect—most oncologists would have predicted—that treating patients in an earlier setting is going to have more benefit than waiting until they have a radiographic relapse.

1:11 | Applying that to the small cell setting and certainly in the limited-stage setting might [help] and I think trials like that would be in order. We have a large biomarker biobanking project related to that across all patients with cancer that we see at AHN, so we're very excited about that approach in terms of early-relapse detection and then introduction of therapeutics at a much earlier stage before you have radiographic relapse.