Expert Point of View: Sumanta K. Pal, MD, and Richard Schilsky, MD


Get Permission


The authors have demonstrated not only the feasibility of the test in detecting alterations, but that the results are often potentially actionable as well... .
— Sumanta K. Pal, MD

Sumanta K. Pal, MD, an ASCO spokesperson who moderated a press briefing at the 2016 ASCO Annual Meeting, commented that the data provide key insights into the feasibility of “liquid biopsy.”

“We’re increasingly using genomic data from day to day in our clinics to guide therapies,” said Dr. Pal. “The authors have demonstrated not only the feasibility of the test in detecting alterations, but that the results are often potentially actionable as well.... As oncologists obtain this assay, it’s important to keep in mind trials such as the ASCO-led TAPUR [Targeted Agent and Profiling Utilization Registry] study. TAPUR can potentially link patients with selected genomic alterations to relevant therapies that would otherwise be challenging to access.”

Referring to the numerous blood-based genomic tests that are emerging, Dr. Pal added, “It will be important to rigorously define which of these platforms deliver optimal results.”


We need more data, and the burden is on all of us to demonstrate the true utility of this testing [blood-based biopsy].
— Richard Schilsky, MD

Richard Schilsky, MD, ASCO’s Chief Medical Officer and former Chief of Hematology-Oncology at the University of Chicago, further commented on this emerging area of cancer research. “This lab and many others are now offering these circulating tumor DNA [ctDNA] tests. I think commercial use is getting a bit out front of the actual data that demonstrate clinical utility, but there are obvious advantages over tissue-based biopsy,” he said.

It is obviously much simpler and safer to obtain information from blood, than solid tissue, especially for some cancers, such as bone and brain, and blood-based results might be available sooner, he said. However, Dr. Schilsky cautioned, “Just because a test can be done, doesn’t mean it should be done. It doesn’t mean it is informative.”

Although the current study “provides important information on the road to demonstrating the clinical utility of liquid biopsy,” he said, “it’s not a prospective randomized trial; it compares clinical experience from a heterogeneous population, most of whom have metastatic disease, to a reference database derived primarily from tumors from patients who do not have metastatic disease and therefore are a different patient population.”

“We need more data, and the burden is on all of us to demonstrate the true utility of this testing,” concluded Dr. Schilsky. ■

Disclosure: Drs. Pal and Schilsky reported no potential conflicts of interest.


Advertisement

Advertisement



Advertisement