ESMO WCGIC 2023 | The future of liquid biopsies in gastrointestinal malignancies
Filippo Pietrantonio, MD, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, talks on the role of liquid biopsies in gastrointestinal cancers. Whilst liquid biopsies are useful to detect novel targets in the metastatic setting, more research is needed to assess their utility in earlier stages. Treatment intensification can additionally be determined by liquid biopsies via minimal residual disease (MRD) monitoring. This interview took place at the ESMO World Congress on Gastrointestinal Cancer (WCGIC) 2023 in Barcelona, Spain.
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Transcript (edited for clarity)
Yes, liquid biopsies are really important. Of course, we have to distinguish between the setting for patients with metastatic disease. We have to select the best assay and the aim is molecular profiling so we can detect the different tumor targets for therapeutic intervention. So liquid biopsy may be really useful to find additional treatment options in the context of both the clinical practice and clinical trials In early stage disease, the field is moving faster even if, for example, according to the ESMO guidelines, the use of liquid biopsy to detect minimal residual disease after surgery is still not recommended because we have interesting data on the role of liquid biopsy in early stage disease showing that these prognostic factor may be the strongest compared to all other available prognostic factors because it is able to differentiate the patients with relapse and cured by surgery with or without adjuvant chemotherapy...
Yes, liquid biopsies are really important. Of course, we have to distinguish between the setting for patients with metastatic disease. We have to select the best assay and the aim is molecular profiling so we can detect the different tumor targets for therapeutic intervention. So liquid biopsy may be really useful to find additional treatment options in the context of both the clinical practice and clinical trials In early stage disease, the field is moving faster even if, for example, according to the ESMO guidelines, the use of liquid biopsy to detect minimal residual disease after surgery is still not recommended because we have interesting data on the role of liquid biopsy in early stage disease showing that these prognostic factor may be the strongest compared to all other available prognostic factors because it is able to differentiate the patients with relapse and cured by surgery with or without adjuvant chemotherapy. And we have a lot of amount of data of course, in colorectal cancer, but some data are emerging also in patients with upper GI tumors such as gastric cancer. But what we really need now is a randomized clinical trials because of course we will have to guide a specific therapeutic intervention based on the results of liquid biopsy, for example, by selecting patients with minimal residual disease after surgery for treatment intensification or those with persistent minimal residual disease after standard adjuvant therapy for consolidation therapy. So for giving additional therapy after completion of the standard of care. So another field is the intensification. So for example, sparing a toxic potentially toxic chemotherapy to patients that really don’t need it because they they were cured by surgery. So they have a negative result. Of course, the technology is moving really fast. So as soon as we will have a highly sensitive assays with a very good specificity, of course the results of the clinical trials could be even better in the future because we will have randomized clinical trials on one side and better technology and more advanced technology on the other side.
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