A substantial article was recently published by Cureus which explores the role of liquid biopsy in diagnosis and prognosis of WHO grade 4 astrocytoma (Glioblastoma), and provides a comprehensive overview of the current state of play for the modality. Here we break down the key information, discuss the overall take-aways and what the future of care looks like for the brain cancer community.
What is a liquid biopsy?
A liquid biopsy is an alternative method of determining the diagnosis and/or prognosis of a condition. It uses biological fluid, or ‘biofluid’, obtained from the body. This may include blood, urine, or cerebrospinal fluid. The biofluid is then sequenced to detect cancer cells, revealing information that can inform, support, or determine diagnosis and prognosis.
Evaluating new methods for disease monitoring is an important area of research in which PRIME plays an active role. Our PRIME service has provided patient involvement support to multiple studies which are utilising liquid biopsies. Across these projects, researchers are determining how liquid biopsies can benefit the treatment pathway for patients as either a primary or secondary aim. Click here to find out more and get involved.
Progress with liquid biopsies
Research into liquid biopsies as a potential tool has been ongoing for decades. But more recently they have become a realistic option for detecting markers of tumours (typically in blood). Our understanding and utilisation of this modality has improved enough that researchers are now exploring how this option could compete with or support our standard practice of monitoring and diagnosing patients.
The latest World Health Organization (WHO) classifications of brain tumours allows for a greater comprehension of how tumours behave and respond to treatments. It is also aiding our ability to understand information collected through liquid biopsy. A useful table outlining the WHO classifications is featured here.
WHO grade 4 astrocytoma (more commonly referred to as glioblastoma) is the most common primary malignant brain tumour in adults. It accounts for 60% of all astrocytoma, and 50% of all primary malignant tumours.
Currently, the standard of care for WHO grade 4 astrocytoma is surgery, radiotherapy and chemotherapy. Molecular testing of tumour samples helps classify the tumour, but these techniques are not cost-effective and can be inconclusive.
It is integral to improving care for our community that we develop methods requiring less intervention. Liquid biopsies present a potential solution.
What are the advantages of liquid biopsies? Are there limitations?
Obtaining biomarkers in blood or cerebrospinal fluid is easy. Furthermore, the biofluid can be measured multiple times, making it a more effective way to monitor disease progression.
Traditionally in standard care, the tumour is removed during surgical resection or a surgical biopsy. These procedures are invasive and have limitations. Limitations include the challenge of preserving tumour samples for sequencing and issues arising when there is not enough sample for a definitive conclusion. Additionally, invasive biopsies can create risk of cognitive complications for the patient spanning from speech impairments, balance or memory to severe health risks or even death.
Liquid biopsies would significantly decrease many of these risks, as well as potentially provide a fuller picture of how the cancer cells are behaving.
Potential drawbacks to liquid biopsy however include the potential for information to be missing in the biofluid. There is also a lot of further research and development necessary to know how best we can utilise this modality, and rely on it for consistent insight on how to best manage and provide appropriate treatment and support to those living with a brain tumour. However, it remains an exciting field of exploration which provides a promising alternative for the outcome and comfort of someone facing a diagnosis.
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If you or someone you love is living with a brain tumour and have any questions around this latest news, or want to access support, give us a call on 01983 292 405 or email email@example.com. You can also visit our little brainstrust website which features support for children affected by brain tumour.