Liquid biopsy, a technique that allows blood tests to “spy” on a tumor and combat it, appears as an ideal tool for diagnosing cancer in its early stages and if it cannot be cured. If so, at least turn it into a chronic disease. This is explained by the director of the ONCOMED research group of the University Clinical Hospital of Santiago de Compostela (Spain), Rafael López, within the framework of the Congress of the European Society of Medical Oncology (ESMO, for its abbreviation in English). was conducted. in Paris. Lopez anticipates that this early detection technology will be widely implemented in a decade.
López says that liquid biopsy should be understood as a form of precise oncology, as it is the only tool that allows us to see “the intimate characteristics of a tumor” today. “There is no other option because the classic biopsy, which is usually expensive, bloody, and inconvenient, studies only a very small piece of the tumor, not the entirety,” he says. This oncologist, who chairs the Foundation for Excellence and Quality in Oncology (ECO), believes that the current means – “the most reliable are CT and PET-CT” – are too primary and that cancer can occur in one billion cells. Observed, “Which is a huge amount. If we want to go deeper and become more effective, we have to lower that threshold.”
Lopez emphasized that liquid biopsy began to be used with patients with advanced tumours, but also in patients with minimal residual disease, that is, those with localized tumours. And he points out that there are tumors that secrete more DNA into the blood than others and that at this point in time, the most benefit from this device would be lung cancer. He recalls that liquid biopsies began to be performed with colon and breast cancers, but stresses that the practice is “extensible to all tumors and to all fluids.”
He believes that the most “comfortable” is blood, but this can be done with cerebrospinal fluid, in the case of metastases with brain involvement, pleural fluid, in urine or saliva. “It can happen to any fluid in the body,” he says.
For this oncologist, liquid biopsy is a “revolutionary” tool that aims to deliver adequate and individualized treatment to the patient, and requires “accurate diagnosis.” And despite its proven effectiveness, this tool is not yet in the portfolio of services of the national health system in Spain, something that happens, in his opinion, because innovations are “difficult to incorporate.”
This expert is convinced that widespread application of this technology will be beneficial in advanced disease, which will have low impact and enable targeted therapies, but above all because of the early diagnosis in minimal residual disease that is necessary and the information it provides. tumor as a whole.
“Future” practice to screen susceptible patients
According to oncologist Rafael López, limiting the tumor and knowing what’s going on will avoid giving unnecessary treatment to many patients, a condition that currently occurs in seven out of ten cancer patients. Lopez is clear that liquid biopsy will be the “early diagnostic screening method of the future,” as he says.
This expert is optimistic about the ultimate goal of curing cancer, something which, in his opinion, will be achieved when it can be diagnosed at a very early stage and the previous stage disease will have to be turned into a chronic disease. Remember that drugs become resistant. Currently, this resistance has changed following TAC indications, “but with a liquid biopsy it is easier to anticipate the change and the result is more effective”.
With this positive outlook, López demands that research be supported, that investments be made to cover the cost of this technology, and that this logistics is positive for both doctors and the healthcare system to be convinced.
Blood test can detect cancer before symptoms occur
According to research presented yesterday at the European Society of Medical Oncology (ESMO) Congress, 50 types of cancer can be detected with a simple blood test in an unknown population without symptoms of the disease.
The study, coordinated by oncologist Deborah Schrag, is touted as a pioneer in the early diagnosis of cancer through a test that detects the presence of circulating tumor DNA in the blood, derived from tumors and present in the bloodstream. Even when no one is there. Symptoms of the disease in the patient.
The research, conducted by oncologists at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, bases its results on blood tests performed on 6,621 people over the age of 50 who were not diagnosed with cancer and had no The disease was not a symptom.
Of these, about 99% gave a negative result, that is, they were free of disease, while 1.4% showed signs of cancer. However, of that 1.4%, only 38% were later confirmed to have cancer with a positive test.
With these results, oncologists understand that early detection of cancer with a simple blood test opens a new era to rule out the presence of disease and improve cancer mortality and morbidity, but not incidence.
Once the test was positive, it took an average of less than two months to confirm the diagnosis if they had cancer and slightly more, about three, if they didn’t. The only disadvantage is that false positives lead to invasive procedures for the patient, such as endoscopy or biopsy.