Cancer: In Italy every year over 8000 patients candidates for liquid biopsy Post & News admin February 22, 2023 Rome, 21 February 2023 â Almost 8,000 lung cancer patients are thought to qualify for a liquid biopsy each year in Italy in order to determine the best course of treatment. But in the not-too-distant future, the number of cancer patients for whom a simple blood test will choose the optimum course of treatment will grow dramatically. A blood sample enables continuous, real-time monitoring of the neoplasm’s development, much like in a video. An image of the tumour at the time of diagnosis can only be captured by a conventional biopsy, which is performed on tumour tissue. Also, even if it doesn’t currently reflect clinical practice, the difficulty is in using a blood test to make an early cancer diagnosis. The study, which is presented in the book “Liquid Biopsy: New Challenges in the Age of Immunotherapy and Precision Oncology,” by Antonio Russo, Ettore Capoluongo, Antonio Galvano, and Antonio Giordano, Ed. Elsevier brings up truly innovative views on the use of liquid biopsy, which was presented today at a press conference in the Chamber of Deputies and has signatures from the top international experts. âTwenty years ago, in 2003, there were fewer than 50 publications in oncology that used the term “liquid biopsy,” but today there are more than 10,000, making it a real “hot topic,” states Antonio Russo, COMU President, Full Professor of Medical Oncology at DICHIRONS – University of Palermo, and Treasurer of AIOM (Italian Association of Medical Oncology). The “Liquid Biopsy” manual serves as evidence of both the prominence of Sicily, specifically the University of Palermo, and the brilliance attained in this subject by Italian scholars across the globe. “Up to this point,â continues Professor Russo, âthe applications of liquid biopsy that have been shown effective in clinical practice involve advanced-stage non-small cell lung cancer, for the assessment of the EGFR gene mutational status. In two clinical contexts, the method is suggested in these instances as a possible alternative for tumour tissue examination. First of all, in patients who have just received a diagnosis and prior to beginning any kind of treatment, when the quantity or quality of tissue available is insufficient to perform the anticipated molecular analyses, when the molecular analysis of tissue has been found to be insufficient, or when it is impossible to obtain biopsy tissue due to the patient’s poor clinical conditions. It should be kept in mind that, even when used for histological diagnosis, the tissue sample is not acceptable for molecular characterization in roughly 30% of instances. In the second scenario, the liquid biopsy provides a very important contribution during the monitoring of patients with EGFR gene mutation, in progression after first-line treatment with targeted therapies, i.e. with first and second-generation EGFR inhibitors. In these cases, blood sampling is very useful for searching for a specific resistance mutation and directing the change of cure, i.e. treatment with the third-generation EGFR inhibitor. The latter, in light of the robust overall survival data, has now become a solid option on the front line and, given the high inhibitory activity, has made the use of liquid biopsy for the search for the resistance mutation secondary”. “The liquid biopsy has undoubted advantages over the traditional approach consisting of the analysis of tumor tissue – says Antonio Giordano, Director of the Sbarro Institute for Cancer Research and Molecular Medicine of Temple University in Philadelphia (USA) and Professor of Anatomy and Pathological Histology at the University of Sien, and Founder and President of the Sbarro Health Research Organization (SHRO). âIt is minimally invasive, low-cost, has very fast reporting times and is practically free of complications because it can be performed with a simple blood sample. Furthermore, it is characterized by a high level of acceptance by patients and can be repeated without problems, by performing serial sampling to highlight the onset of resistance to therapy in real-time and, if necessary, modify the treatment.â âThe liquid biopsy has undeniable advantages over the conventional method that involves the study of tumour tissue,â says Antonio Giordano, Director of the Sbarro Institute for Cancer Research and Molecular Medicine of Temple University in Philadelphia (USA) and Professor of Anatomy and Pathological Histology at the University of Siena, âIt is less invasive, inexpensive, has extremely quick turnaround times, and is essentially complication-free because it can be carried out with a simple blood sample. Furthermore, serial sampling is used to highlight the development of therapy resistance in real-time and, if necessary, change the treatment. It is characterized by a high level of patient acceptability and can be repeated without issues. Instead, very few patients opt to have a second tissue evaluation, in part because the general clinical circumstances often exclude it. Moreover, the tissue biopsy sample, particularly when it is obtained through fine-needle aspiration, may not necessarily be an accurate representation of the entire tumour. This is not the case with the liquid biopsy, which solves the issue of the heterogeneity of the tumour tissues by analyzing the tumour DNA discharged into the circulation.” The predominant biopsy method currently utilized in clinical practice today is the examination of circulating tumour DNA, or ctDNA (circulating tumour DNA), which is a fraction of circulating free DNA (cell-free DNA, or cfDNA), isolated from peripheral blood (particularly from plasma). âThe chance of success is dependent on the quantity of ctDNA in the peripheral blood, which may impact the test’s sensitivity,â underlines Ettore Capoluongo, Full Professor of Clinical Biochemistry and Clinical Molecular Biology and SOC Director of Clinical Pathology and Genomics, Cannizzaro Hospital of Catania, âOne drawback is that, depending on the volume and locations of the disease, the amount of ctDNA in the context of cfDNA is frequently limited, and this might result in “false negative” results on the liquid biopsy sample. The size and stage of the tumour are really connected to the concentration of ctDNA in plasma, with advanced-stage neoplasms releasing more ctDNA than early-stage ones.… Continue reading Cancer: In Italy every year over 8000 patients candidates for liquid biopsy