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Liquid Biopsy-based Test As Good As Tissue-based Test for Identifying Treatment for Lung Cancer

(AACR) Feb 27, 2019 - Guardant360, a liquid biopsy test that detects all guideline-recommended biomarkers in newly diagnosed metastatic non-small cell lung cancer (NSCLC), detected biomarkers at a rate similar to that of standard-of-care tissue genotyping tests but with a faster turn-around time, according to data presented during a media preview of the AACR Annual Meeting 2019, to be held March 29-April 3, in Atlanta. “About 30 percent of lung cancers can now be treated with molecularly targeted therapies and the response rates using these treatments are much higher than with chemotherapy,” said Vassiliki Papadimitrakopoulou, MD, professor of medicine in the Department of Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center. “But to identify patients who will benefit from these therapies, we need to ensure all patients are tested for these targetable mutations.”

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H. Jack West, MD (Posted: March 01, 2019)

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We obviously need to see the actual data at the AACR presentation, but this is an important milestone, I expect. Blood-based testing had already gotten a big boost by the paper from Charu Aggarwal and colleagues in JAMA Oncology in ~Oct, 2018, and this presentation will likely bolster confidence among oncologists that blood-based NGS testing is now sufficiently sensitive and established to be used far more broadly.

Significantly, I think this will do a lot to lead to more patients getting NGS testing and greater detection of many targets. The oncologists committed to molecular testing were likely to get it even if it required an additional tissue biopsy -- it was those who were more skeptical or those who didn't want their patients or themselves to deal with the hassle of a tissue biopsy who will now take the path of far less resistance and order a blood-based test they can obtain right in the clinic lab and get their molecular testing that way. And the fact that it comes back a week or more before the tissue NGS test results is a further benefit that has been a significant barrier to broad adoption of NGS testing, at least tissue-based NGS testing, up to this point.

I eagerly await the data, but the abstract strongly suggests that this will be a big year for blood-based NGS testing.

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