The biggest winner of COVID was liquid biopsy (LB), as interventional surgeries for biopsies simply weren’t happening during much of the pandemic. LB was a phenomenal solution and the restrictions due to COVID certainly propelled its advancement during the last couple of years. We had the opportunity to leverage LB for cancer patients showing the world the potential for early cancer detection and also imagining what was possible with LB. I certainly believe LB wouldn’t have had the same opportunity if it weren’t for COVID. We had no choice but to adopt LB.
Scientifically, COVID also helped engage the ecosystem. People rallied around the case for LB which resulted in scientific advancements such as allowing us to see the level of granularity obtainable from blood that we had originally thought could only be seen in tissue. An exciting example is prostate cancer where the prognostic capability of LB is well established. The LB technology has proven valuable for the identification of changing biomarkers that can serve as a surrogate for clinically relevant endpoints. This is even more important and relevant with cancers, such as prostate cancer, where biopsies are very invasive. Identifying actionable mutations using LB to guide treatment decisions is now a reality for prostate cancer patients (e.g., PARP inhibitors). Many of the mutations that are tracked through solid tissue – which used to be the gold standard – can now be tracked through LB.
And then, of course, LB will enable earlier cancer detection – a very critical aspect which will reduce the need for invasive diagnostic procedures that more typically are triggered by severe symptoms related to later stage cancers. Routine early cancer screening has been shown to have a tremendous impact on patient survival rate and overall treatment cost – a plus for the entire health care community. LB will also play an important role in cancer patient monitoring during late stages, e.g., to assess response to treatment. Certainly, we are not there yet and lots of work is still required to reach the right mix of sensitivity and specificity to be able to broaden the screening across many cancer types. Industry entities need to work together (e.g., pharma, testing companies, government, and regulatory bodies), data needs to be pulled into the public sector, and regulators need to find the right comfort level and be engaged.
Lastly, another hot topic is cancer prediction. Determining whether we can identify the tumor of origin with Minimal Residual Disease (MRD) testing, via cell-free DNA analysis, is a big focus area – fragmentomics and proteomics play a huge role here.
Certainly, we are still facing numerous challenges that we need to overcome such as getting enough stage I and II patient samples for rare cancer types (e.g., cholangiocarcinoma) or continuing to share data post-COVID, which is one of the main objectives for the PMWC January 25-27, 2023 Silicon Valley conference (Full Program / Register) for getting the different stakeholders into one room to expedite identification and delivery of possible solutions to those challenges.
I am so excited to chair the “Clinical Utility of Liquid Biopsies” track at PMWC 2023 Silicon Valley, on January 26. We have an exciting program put together that promises to touch on all those critical aspects. Here are some program highlights that I want to share with you:
• PMWC 2023 Award Ceremony
o Luis Alberto Diaz Jr. (MSK) Assisted in pioneering the application of circulating tumor DNA as a cancer diagnostic and a strategy for monitoring emergence of therapeutic resistance in the blood
o Razelle Kurzrock (Medical College of Wisconsin) Pioneered precision medicine clinical trials & studies in the US and around the world, and the use of liquid biopsy to predict immunotherapy
• Non-invasive Liquid Biopsy Techniques – a panel chaired by Razelle Kurzrock (Medical College of Wisconsin) with Apostolia Tsimberidou (MD Anderson), Mandana Kamgar (MD Medical College of Wisconsin), Mina Nikanjam (UCSD), and Ash Alizadeh (Stanford University)
• Liquid Biopsy Challenges and Limitations – a panel with Mohammed Kashani, Sutter Health, Dana Dilbeck (Agilent), Luis Alberto Diaz Jr. (MSK) and Maximilian Diehn (Stanford)
• Liquid Biopsy in Clinical Trials: Learnings and COVID Experience – a panel chaired by Cindy Perettie (Roche Diagnostics) with Andrew Mckenzie (Sarah Cannon) and Carl Barrett (Astra Zeneca)
• Multi-Cancer Early Detection Through Multi-Biomarker Class Liquid Biopsy Testing – chaired by Tom Beer (Exact Sciences)
• Liquid Biopsy for Early Cancer Detection – a panel chaired by Priti Hegde (Foundation Medicine) with Mike Nolan (Freenome), Jeffrey Venstrom (GRAiL), Kathryn Phillips (UCSF), Daniel Kim, UCSC and Lon Castle (eviCore Healthcare)
• Liquid Biopsy for Minimal Residual Disease (MRD) – chaired by Minetta Liu (Natera) panelists: Peter Bach (Delfi Diagnostics), Laura Vantveer, UCSF and Nitin Sood, Adaptive Bio
• PMWC Showcase with Harmeet Dhani (Biological Dynamics) and Varsha Rao (Claret Bio) and a PMWC NCI Showcase with Xianghong Jasmine Zhou (EarlyDiagnostics)
I hope to see many of you Join Us for this most exciting track at PMWC January 25-27, 2023 Silicon Valley and the ensuing discussions that will help shape the future impact of liquid biopsy.
Head of Roche Molecular Labs, Roche Diagnostics
Liquid Biopsy Track Chair, PMWC 2023 Silicon Valley – January 25-27, 2023