Oncologists Using Blood Samples As A Monitoring Tool for Mesothelioma Patients Urged to Use With Caution – MesotheliomaHelp.org (blog)

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Researchers have been focusing more on the use of liquid biopsies in advanced stage cancer patients as a non-invasive means to manage treatment and to assess progress. Without the need for a painful tissue biopsy, researchers report analyzing circulating tumor cells in mesothelioma, and other patients, for specific biomarkers can guide treatment and improve the success rates for oncologists. Now, an expert review panel is urging caution in relying on the results to guide patient care outside a clinical trial setting.

MesotheliomaHelp has reported numerous times on the benefits of liquid biopsies, or blood tests, in diagnosing and treating mesothelioma and other cancers. The tests are touted as being less painful, less risky and just as effective for analyzing mesothelioma and lung cancer biomarkers.

Recently, the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) reviewed 77 articles related to liquid biopsy studies, published from January 2007 to March 2017. The panel determined liquid biopsies still lack evidence to support their use in routine cancer care, according to a March 29 article in Cancer Network.

“There is no evidence of clinical validity and clinical utility to suggest that ctDNA [circulating tumor] assays are useful for cancer screening, outside of a clinical trial,” the team concluded.

Mesothelioma patients must often undergo invasive and painful biopsies to extract diseased tissue for diagnosis. Tissue biopsy results can take 10 days, leaving patients worried and missing out on treatments. Advocates of blood biopsies claim through a simple blood sample, oncologists can quickly determine an effective treatment. Biopsies return the presence or absence of specific biomarkers that oncologists can pinpoint for treatment. This personalized approach optimizes the potential for success.

Pleural mesothelioma is a cancer of the lining of the lungs caused by past asbestosexposure. The cancer is diagnosed in close to 3,000 Americans each year.  There is no cure for the cancer.

Researchers from Johns Hopkins Medical Center report that the CancerSEEK liquid biopsy test can detect eight common cancer types by looking at DNA mutations, according to a February  Cancer Network report. But, the team also urges caution saying, “We don’t want to overpromise anything and it is vital to validate in studies to make sure it translates into a real survival benefit.”

On June 1, 2016, the U.S. Food and Drug Administration announced approval of the first liquid biopsy test to detect the EGFR mutation in lung cancer patients. The cobas EGFR Mutation Test v2, is a companion diagnostic for the cancer drug Tarceva (erlotinib), an EGFR tyrosine kinase inhibitor used to treat lung cancer and mesothelioma. According to some reports, the EGFR gene is overexpressed in more than 50% of pleural mesothelioma patients.

“The ability to genotype tumors from blood samples is going to be transformational for oncology and pathology. But, we are in early days,” said co-chair of the ASCO and CAP expert panel Alexander Lazar, MD, PhD, University of Texas MD Anderson Cancer Center.

The panel recognizes that continued research into liquid biopsy usage may still bring breakthroughs, saying, “Given the rapid pace of research, re-evaluation of the literature will shortly be required, along with the development of tools and guidance for clinical practice.”

Read more about blood biopsy validity in the March 5 issue of the Journal of Clinical Oncology.

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