It’s a great question. Really, a lot of the research in the field for brain tumor biomarkers and liquid biopsies up to this point has been in plasma. There’s been a limitation of the fact that there’s a blood-brain barrier, which limits the amount of brain tumor biomarkers that can make their way into circulation. And so sensitivity has often been limited up to, you know, even up to 50% of detection...
It’s a great question. Really, a lot of the research in the field for brain tumor biomarkers and liquid biopsies up to this point has been in plasma. There’s been a limitation of the fact that there’s a blood-brain barrier, which limits the amount of brain tumor biomarkers that can make their way into circulation. And so sensitivity has often been limited up to, you know, even up to 50% of detection. So the idea of using plasma for disease monitoring in patients with brain tumors has really been challenging. And so because of that, I don’t know that we necessarily have a great response yet in terms of what do the dynamics look like in plasma compared to CSF. I think CSF, one of its benefits is that it does bypass that issue of the blood-brain barrier, but it also has its own limitations in terms of tumor to CSF contact, which is not something that plasma has to deal with. But I think, you know, as we gain more and more experience with either plasma or CSF as liquid biopsy sources and as technologies develop, I think we’ll be able to answer that question more clearly. There are some really exciting technologies and tools like AmpliSeq and plasma that I think, you know, our group has demonstrated tracks really well with disease burden and can even predict disease progression weeks and months before it occurs. Still, you know, small sample sizes, still working on developing those assays out and validating them in more patients. But I think we’ll see, hopefully, that there are similarities in the dynamics between the two. And that really, as we have more tools available in both plasma and CSF, they can be used complementarily. So for example, if we’re trying to see disease progression around a resection cavity, well, CSF can likely capture that very well. But if there’s disease progression happening away from the resection cavity or away from a CSF space, then in that case, we’ll need some really strong plasma tools because plasma can more, you know, fully sample all areas of the brain and the tumor than CSF can. So still a lot of unanswered questions there in terms of dynamics, but it’s a really exciting space to be in, especially as we have more and more tools to be able to look at both CSF and plasma for biomarkers in these patients.
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