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Liquid Biopsy on the Rise

Oncology Report 1/2018

Today, liquid biopsy is widely used as a precision diagnostics tool for different applications and is especially helpful in improving cancer management. One of the important aspects is to analyse therapeutic target structures and resistance mechanisms as well as monitoring the patients undergoing targeted therapy.






Prof Léa Payen works at the Cancer Research Institute of Lyon
and at the hospital Hospices Civils of Lyon

Prof Léa Payen and her team at the Hospices Civils de Lyon, France, are using the OncoBEAM RAS CRC kit in a project called OncoCIRCAN. In this project, scientists and clinicians are investigating circulating cancer markers and their use for molecular diagnostics in lung and colorectal cancer.

What are the current challenges in cancer management?
Prof Léa Paye n: Today, when managing cancer, the challenge is to be able to adapt the treatment to the patient at every stage of the disease. In order to choose between the available therapeutic methods, one must have robust predictive or prognostic biomarkers. The future challenge will be to evaluate the tumour heterogeneity in all  patients and predict the evolution of the various tumour clones under pressure from different lines of therapy.

What is the advantage of liquid biopsy and when do you use OncoBEAM?
The major advantage of liquid biopsies is that it is a minimally invasive procedure that can be repeated any time. This allows patient monitoring during the course of the disease. It is used for the diagnostics of colo-rectal and lung cancer when we have no DNA from tissue biopsies.
In colon cancer, the presence of a KRAS and NRAS mutation in the colon precludes the prescription of anti-EGFRs. We have also validated the use of OncoBEAM for the molecular diagnostics of lung cancer. The presence of a KRAS modification in cell-free DNA (cfDNA) will steer management towards classic chemotherapy.

Why does sensitivity matter?
The cell free tumor DNA is generally mixed with a substantial amount of cfDNA secreted by healthy body cells. One must therefore be able to detect the mutated DNA which is diluted and poorly represented in the total circulating DNA. Given that this is a major therapeutic challenge, we must be as close as possible to 100% correlation with positive tissue biopsies in order to provide clinicians with a useful result.
We have observed that the sensitivity of BEAMing was at least ten times higher than other digital PCR technologies (BioRad) or the Illumina NGS technique using amplicon targeted libraries. We have been able to detect po-sitive cases in the plasma of patients with an otherwise negative biopsy, which was mostly consistent with the response to treatment. This helps to complement the patient's mo-lecular diagnosis. You have been the first to evaluate the new OncoBEAM EGFR Kit.

Why did you choose OncoBEAM for EGFR testing and what is your impression of its performance so far?
In our laboratory, we have chosen to establish the molecular profile of patients' cell-free DNA both with an amplicon-based NGS strategy, for its wide coverage, and with the more sensitive and specific OncoBEAM tests for actionable mutations which provide additional information. These complementary approaches reduce the risk of false negatives and allow better patient monitoring. The OncoBEAM EGFR kit is highly sensitive and allows us to detect the mutation earlier during progression. The partnership with SYSMEX is special since we are not just users.
We closely collaborate in order to validate new assays and optimise workflows by sharing our experience using the assays.

How will such a liquid biopsy test influence/ change NSCLC patient management?
At diagnosis, the use of the OncoBEAM EGFR test will help detect the presence or absence of actionable mutations with high sensitivity and specificity. Eventually, this will allow the treatment protocol to be tailored to the patient on the basis of the information obtained from the liquid biopsy.

Fotoquelle: Lea Payen-Guy

Xtra Online – Onkologie

Liquid Biopsy mit OncoBEAM

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