Chris Martin | IASLC media Contact | [email protected]
Denver—The International Association for the Study of Lung Cancer today published a new consensus statement on liquid biopsy use for non-small cell lung cancer. The report appears in the current issue of the Journal of Thoracic Oncology and is available here: https://www.jto.org/article/S1556-0864(21)02284-X/pdf.
The report is an update from the IASLC consensus statement in 2018 and was written by a distinguished international group of lung cancer clinicians and researchers expert in the field, led by Christian Rolfo, MD, PhD, MBA, DRhc, associate director for clinical research at the Center for Thoracic Oncology, The Tisch Cancer Institute, Mount Sinai Health System and professor of Medicine at Icahn School of Medicine, New York City, and David Gandara, MD, director of thoracic oncology, professor of medicine emeritus, and senior advisor to the director at the University of California Davis Comprehensive Cancer Center, Sacramento, Calif.
Since the publication of the first IASLC liquid biopsy statement in 2018, important additional advances have been made in this field, leading to changes in the therapeutic decision-making algorithm for advanced NSCLC and prompting this 2021 update.
“It is notable that the IASLC has taken the lead in detailing the current state of the art in this rapidly expanding field,” stated Dr. Gandara, senior author of the statement. “Non-small cell lung cancer, in particular, is an ideal disease area for application of liquid biopsy due to increasing availability of targeted therapies for this genomically complex malignancy. Liquid biopsy, and especially plasma ctDNA, can be used in many clinical settings where tissue is not applicable, such as the detection of minimal residual disease (MRD). We anticipate the opportunities for liquid biopsy will continue to expand, and we are pleased that IASLC is in the forefront in this arena.”
Although tumor tissue is historically the gold standard biospecimen for these molecular analyses, there are significant innate limitations discussed in the report. According to the new report, the liquid biopsy approach includes a variety of methodologies for circulating analytes. From a clinical point of view, plasma circulating tumor DNA (ctDNA) is the most extensively studied and widely adopted alternative to tissue tumor genotyping in solid tumors, including NSCLC, first entering clinical practice for detection of epidermal growth factor receptor (EGFR) mutations in NSCLC.
In view of the novel and impressive technologic advances made in the past few years, the growing clinical application of plasma-based next-generation sequencing and the recent U.S. Food and Drug Administration approval of two different assays for ctDNA analysis, IASLC revisited the role of liquid biopsy in therapeutic decision making in a workshop in October 2020. The workshop focused on attempting to discern benefits and challenges to a plasma-first approach to molecular testing for advanced NSCLC. Moreover, evidence-based recommendations from IASLC provide an international perspective on when to order which test and how to interpret the results.
“The IASLC continues to demonstrate the leadership in lung cancer, offering this new statement for better application of liquid biopsy,” said Dr. Rolfo. “In the current version, we incorporated all the recent evidence in the field, creating a very useful educational material. Liquid biopsy is the present and understanding the benefits and the challenges is mandatory for anyone who is treating lung cancer. The future of the liquid biopsy is fascinating, creating new boundaries for early detection or cancer interception. We hope that is technology becomes available worldwide for all patients.”
The upcoming 2021 World Conference on Lung Cancer, to be held September 8-14, will feature several abstracts focused on liquid biopsy methodologies and use for lung cancer screening, diagnosis, and therapeutic efficacy. A new track was added to house these abstracts, allowing attendees more convenient navigation of the latest liquid biopsy-related data.