So it turns out that, you know, brain cancers, and I’ll use glioblastoma as a typical example, are one of the cancers where liquid biopsy would potentially have the most value. And that’s because, you know, repeated brain tissue acquisition through biopsies or surgical resections is not really safe or feasible in the vast majority of patients. And so the ability to either detect the presence of a tumor or to molecularly profile the tumor serially during the course of the patient’s disease without having to do invasive brain tissue acquisition would be a major advance...
So it turns out that, you know, brain cancers, and I’ll use glioblastoma as a typical example, are one of the cancers where liquid biopsy would potentially have the most value. And that’s because, you know, repeated brain tissue acquisition through biopsies or surgical resections is not really safe or feasible in the vast majority of patients. And so the ability to either detect the presence of a tumor or to molecularly profile the tumor serially during the course of the patient’s disease without having to do invasive brain tissue acquisition would be a major advance. So this is unfortunately, although it’s a recognized unmet need, hasn’t really panned out yet in the blood, at least. And some of the reasons are the presence of the blood-brain barrier. So you simply don’t get that much tumor-derived cell-free DNA or other tumor-derived materials circulating in the bloodstream of glioblastoma patients. The other issue is that the tumor just may not shed as much DNA into circulation as other cancers might. It’s a localized disease to the brain typically, and so you’re not in a situation where you have widespread metastases and lots of potential for tumor shedding. So I think for those reasons, all of the liquid biopsies that have become relatively standard across many other cancers, when you try to use them in the clinical management of glioblastoma, they’re just not sensitive enough. And so, you know, we, in my practice, and I know in the practice of many other of my colleagues, we’re not typically ordering blood-based liquid biopsies on our brain cancer patients as a matter of routine care.
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