April 4, 2018
Two publications hit the hype about liquid biopsies. The first was from Dr. Alda Tam from the MD Anderson Institute in Houston. She rightfully indicated "Why biopsy is the key to personalised medicine" and made a strong case for the radiological interventionist and the innovations that are needed in biopsy tool design. Exactly what Bionice is doing for almost 20 years now.
The second publication from Dr. Hu et al. of the Lowe Center for Thoracic Oncology and Belfer Center for Applied cancer science Dana-Farber Cancer Institute in Boston pointed to false positive plasma genotyping in liquid biopsies and difficulties in guidance of precision medicine.
These are two examples of data that arouse utility problems about liquid biopsies in guidance of targeted treatments. But there is also the isssue of using the right words with the right definitions.
Measurement of tumor associated molecules is a priority in oncology for detection, diagnosing, and monitoring cancer patients. It is widely known that the tumor markers we now use for, for example lung and breast cancers, are largely insufficient. Not even 5% of women with established breast cancer have a rise in CA 15.3 at diagnosis while it is the most frequently used tumor marker. So we badly need tumor markers on which we can rely on to monitor the disease, but also to detect cancer in its most early stage. With the exceptions of some rare tumors (trophoblastic disease) and to some extend PSA in prostate cancer, we have none.
The trouble in definitions has come from naming this type of tumor marker research: "Liquid biopsies". This name has created much confusion but essentially was inspired by the strong demand for liquid phase human samples for molecular biology, an exploding discipline in oncology. The gigantic wave of molecular biology labs worldwide, in all universities, and even more in commercial labs all need liquid phase samples. This is in contrast with microscopical analyses where sliced but solid tissues need to be studied.
There are several types of tissues that can be offered to the lab in a liquid phase. Of course, readily to find are body fluids such as plasma, saliva, urine. They can easy be obtained by punction, swab, or drainage. But tissue, harvested by surgery or biopsy, can be homogenized as well and studied in a liquid phase. Calling body fluids liquid biopsies creates confusion. By the way, contemporary research has made minimal invasive techniques almost painless and comfortable with excellent quality of samples.
Creating liquid phase tissue samples from solid tissues is a critical conversion. For this we wrote already another white paper.
The Bioncise Team