Liquid Biopsy Study Shows Test Accurately Guides Care in NSCLC When Tissue Unavailable

Not having enough tissue is often a problem in precision medicine. The senior author of a new study said a liquid biopsy could become a new standard.

An amplicon-based next-generation sequencing liquid biopsy accurately and reliably detected clinically relevant molecular alterations in patients with non—small cell lung cancer (NSCLC), making it a reliable tool compared with standard of care, according to a study published this week.

Inivata announced results of a real-world study of its InVision test, which were published in JCO Precision Oncology.1 The liquid biopsy, which evaluates 36 key genes in lung cancer, secured a molecular profile in a significantly higher share of patients than physicians were able to gain through tissue testing, according to a statement from the company.

“In this study, the use of liquid biopsy enabled patients to receive personalized treatments in the absence of a successful tissue biopsy, highlighting its potential to make a meaningful difference to cancer care,” Benjamin Besse, MD, PhD, senior author of the study, said in the statement. Besse is chairman of the cancer medicine department at Gustave Roussy, where the research took place.

Besse said that although biomarkers cannot give a diagnosis of cancer, liquid biopsies are easy to manage in real-world settings, and he anticipates that they will become standard in NSCLC to spare patients the pain of tissue biopsies. Also, tissue samples can become depleted if additional tests are needed.2

According to the abstract, the study involved 214 patients with advanced NSCLC who were recruited for the study, including 156 who were treatment naïve and 58 who were previously treated with unknown tissue molecular profiles. The study found that:

  • ctDNA screening was successful in 91% (n = 194) of the patients.
  • Mutations were found in 77% of the patients.
  • Tissue molecular analysis was available for 111 patients (52%).
  • Tissue somatic mutations were found for 78% (n = 87) of patients.
  • Concordance between ctDNA and tumor tissue analysis was 95% among 94 treatment-naïve patients who had concurrent liquid and tumor biopsy molecular profiles.
  • Sensitivity and specificity were 81% and 97%, respectively.

There were 103 patients with NSCLC with no tissue available, and ctDNA detected potential actionable mutations in 17% of patients. Of this group, 10% received personalized treatment. The personalized testing was associated with a response rate and progression free survival in 31 patients who were treated with first-line platinum-based chemotherapy.

References

  1. Remon J, Lacroix L, Jovelet C, et al. Real-world utility of an amplicon-based next-generation sequencing liquid biopsy for broad molecular profiling in patients with advanced non—small-cell lung cancer [published March 6, 2019]. JCO Prec Oncol. doi: 10.1200/PO.18.00211.
  2. Aisner DL, Rumery MD, Merrick DT, et al. Do more with less: tips and techniqes for maximizing small biopsy and cytology specimens for molecular and ancillary testing: the University of Colorado Experience [published online September 9, 2016]. Arch Pathol Lab Med. doi: 10.5858/arpa.2016-0156-RA.