A liquid biopsy could help to identify cancer patients who are at risk of their disease spreading, a conference heard yesterday (15 May 2019).
Researchers at The Royal Marsden NHS Foundation Trust, London, told delegates at the EACR-ESMO joint conference that ctDNA could be used to monitor treatment response in patients with locally advanced rectal cancer.
This would allow the treatment to be adapted or changed early to prevent the disease spreading.
The research team analysed liquid biopsies from 47 patients at The Royal Marsden who had localised rectal cancer. Blood samples were taken before, during and after patients had completed treatment with combined chemotherapy and radiotherapy (CRT), and after surgery.
The researchers detected ctDNA in 74% of patients pre-treatment, 21% of patients mid-way through CRT, 21% after CRT and 13% after surgery. They found that ctDNA results at the end of CRT were associated with tumour response to CRT as shown on MRI scans.
In a follow up, which took place over a median of just over 2 years, they found ctDNA results were consistent with occurrences of cancer spreading outside of the rectum, while patients for whom ctDNA persisted throughout treatment were more likely to develop metastatic disease sooner.
Lead author Dr Shelize Khakoo, medical oncologist at The Royal Marsden NHS Foundation Trust said: "If we can predict early on who will go on to develop metastatic disease, we might be able to tailor treatment by making it more intense or trying an alternative."
Co-lead author Professor David Cunningham OBE, consultant medical oncologist at The Royal Marsden NHS Foundation Trust said the results suggest that liquid biopsies can provide an accurate method of establishing the cancer’s activity throughout the body.
"Importantly what this study showed, which has not yet been explored, is that persistence of ctDNA mid-way through treatment could be an early indicator of the cancer’s potential to spread,” he said.
“Using this measure, along with MRI scans, we can offer a more personalised treatment approach for patients."
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