How Liquid Biopsies are Creating Diagnostics for a Less Painful Tomorrow

When a patient exhibits a suspicious lump, one of the first things a doctor will do, as a caretaker, is going to be a biopsy. As the leading cause of death worldwide, cancer is responsible for around one in six deaths. So, what can we, as part of the scientific community, do about it?

What is a Liquid Biopsy

Simply put, a liquid biopsy is a type of blood test that looks for relevant biomarkers associated with particular diseases in a sample of the patient’s blood. While this type of biopsy has been gaining traction as an efficient way to detect, monitor, and study tumors without having to resort to surgery or other invasive procedures, it does not replace the need for a tissue-based diagnosis. 

Liquid biopsies can provide a wealth of information (typically molecular data) about the state of disease in a patient. Liquid biopsies can detect:

• Circulating Tumor Cells (CTCs): are a cancer cell from a tumor that is in a patient’s bloodstream

• Circulating Tumor DNA (ctDNA): is a fragment of DNA from the CTC that contains genetic material that dictate the cell’s behavior

• Other: Extracellular Vesicles (EV), RNA, miRNA, DNA modifications (e.g. methylation), Proteins

When used for oncology indications, these materials can provide evidence that a patient has a cancerous tumor. They can also be used to provide information that will help doctors understand the exact type of cancer, its progression, and possible treatment options.

Though the use of liquid biopsies is relatively new, it provides several groundbreaking uses. 

How is a Liquid Biopsy Different from a Biopsy? 

A liquid biopsy often uses blood drawn from a patient to detect tumors, rather than the more invasive biopsy that removes a piece of tissue. A biopsy is considered standard for diagnosing cancer. However, liquid biopsies still provide vital information about cancer cells that can help to create a personalized treatment plan for patients. 

Advantages to Liquid Biopsies

Minimally Invasive 

Liquid biopsies are more minimally invasive than traditional tissue biopsies. They do not require any incisions or tissue samples, and the sample can be obtained from a simple blood draw. This makes them ideal for those with sensitive skin or anxiety about procedures. This also allows for more frequent, serial samplings to assess the behavior of tumors and therapy responsiveness. 

Avoids Biopsy Complications

Traditional tissue biopsies may lead to infection or other complications. Liquid biopsies also reduce the risk of spreading cancer cells throughout the body, which is a potential consequence of tissue biopsies.

Fast and Accurate Results

Time is critical when looking for medical answers. Researchers have observed that liquid biopsy delivers results up to 10 days faster than tissue biopsy. The results obtained from liquid biopsies are often more accurate than those from traditional tissue biopsies, as they can provide better information about how the cancer is progressing throughout the body. Additionally, liquid biopsies can detect mutations that may be missed by tissue biopsies.

Less Expensive

Liquid biopsies are often less expensive than traditional tissue biopsies because they require fewer resources and shorter preparation times. The cost of these tests has been decreasing over time, making them more accessible to a wider range of people.

Representative of the Entire Tumor Burden

Liquid biopsies can provide more comprehensive information than tissue biopsies because they are capable of detecting cancer cells even in the absence of a tumor. This allows doctors to gain insight into mutations that may be present throughout the entire body, rather than just at one site. Additionally, liquid biopsies can detect circulating tumor cells that have not yet formed a tumor and are otherwise difficult to detect with traditional imaging techniques.

Improved Diagnosis and Treatment Options

The data obtained from liquid biopsies can be used to inform diagnoses and provide more precise treatment options. For example, the genetic information from a liquid biopsy can help doctors determine if a patient has cancer that is caused by a gene mutation or if it developed due to other factors. 

Shorter Turnaround Time

Compared to traditional biopsies, liquid biopsies have a much shorter turnaround time. Traditional biopsies can take days or weeks to process and analyze, while liquid biopsies can provide results in as little as 24 hours. This shorter turnaround time can help doctors make quicker decisions about treatments or even move forward with clinical trials for new drugs.

When is a Liquid Biopsy Performed?

Liquid biopsies may be performed for many reasons, however the most common are detection/screening, to determine a prognosis, to make a treatment decision, and to monitor a patient’s condition.

Detection and Early Screening

Screening for cancer regularly can often help at the early stages, when cancer is often easier to treat. The earlier a cancer is detected, the greater the chances of recovery and successful treatment. A liquid biopsy can be used to detect and screen for early signs of certain types of cancer, like breast, lung, prostate, or colon. It can also be used to detect genetic mutations linked to cancer in individuals who have not yet been diagnosed with any form of cancer. 

Determining Prognosis

A liquid biopsy can be used to determine a prognosis for a cancer patient. In many cases, the results of this type of examination can help to inform decisions made regarding the choice of treatment plan and the expected outcome.

Make Treatment Decisions

Liquid biopsies are often used as part of a comprehensive evaluation process that is used to inform treatment decisions for cancer. This can include the use of imaging techniques, such as CT scans or MRI scans, that can help to identify the stage and spread of a tumor. The results of a liquid biopsy may also be used to determine whether a patient is eligible for certain types of treatments, such as targeted therapy or immunotherapy. 

Monitor Tumor Response

As treatments are administered, it is important to monitor the response of a tumor. This can be done through imaging techniques or by analyzing changes in biomarkers that are associated with a certain type of cancer. Liquid biopsies can provide valuable insight into the effectiveness of a treatment regime. By comparing the results from multiple liquid biopsy tests over time, it is possible to gain a better understanding of how the tumor is responding. This allows doctors to adjust treatment regimens accordingly in order to maximize the effectiveness of therapy.  

How Does it Help with Cancer Detection 

The information gathered through monitoring the tumor response can also be used for cancer detection and diagnosis. By analyzing changes in biomarkers or imaging data, it is possible to detect tumors at an early stage and make an accurate diagnosis. This helps you identify the best course of treatment and determine which treatments are most likely to be effective. However, like everything, there are upsides and downsides to liquid biopsies. Let’s review some of them.

Advantages to Liquid Biopsies

Minimally Invasive 

Liquid biopsies are more minimally invasive than traditional tissue biopsies. They do not require any incisions or tissue samples, and the sample can be obtained from a simple blood draw. This makes them ideal for those with sensitive skin or anxiety about procedures.

Avoids Biopsy Complications

Traditional tissue biopsies may lead to infection or other complications. Liquid biopsies also reduce the risk of spreading cancer cells throughout the body, which is a potential consequence of tissue biopsies.

Accurate Results

The results obtained from liquid biopsies are often more accurate than those from traditional tissue biopsies, as they can provide better information about how the cancer is progressing throughout the body. Additionally, liquid biopsies can detect mutations that may be missed by tissue biopsies.

Less Expensive

Liquid biopsies are often less expensive than traditional tissue biopsies because they require fewer resources and shorter preparation times. The cost of these tests has been decreasing over time, making them more accessible to a wider range of people.

Representative of the Entire Tumor Burden

Liquid biopsies can provide more comprehensive information than tissue biopsies because they are capable of detecting cancer cells even in the absence of a tumor. This allows doctors to gain insight into mutations that may be present throughout the entire body, rather than just at one site. Additionally, liquid biopsies can detect circulating tumor cells that have not yet formed a tumor and are otherwise difficult to detect with traditional imaging techniques.

Improved Diagnosis and Treatment Options

The data obtained from liquid biopsies can be used to inform diagnoses and provide more precise treatment options. For example, the genetic information from a liquid biopsy can help doctors determine if a patient has cancer that is caused by a gene mutation or if it developed due to other factors. 

Shorter Turnaround Time

Compared to traditional biopsies, liquid biopsies have a much shorter turnaround time. Traditional biopsies can take days or weeks to process and analyze, while liquid biopsies can provide results in as little as 24 hours. This shorter turnaround time can help doctors make quicker decisions about treatments or even move forward with clinical trials for new drugs.

Disadvantages

Concerns Regarding Sensitivity

Liquid biopsies have been found to be less sensitive than traditional methods, meaning they may not detect certain types of genetic mutations. In addition, some gene mutations that are detected by liquid biopsies may not be associated with a particular disease or may have no clinical significance.

Lack of Spatial Context of Biomarker 

Liquid biopsies can only identify what is present in the liquid sample. This means that it may not provide spatial context of biomarker distribution, which traditional biopsy methods are able to do. Traditional biopsy methods offer more insight into the disease and can give you a better understanding of a patient’s condition.

Lack of Concordance with Tissue 

Liquid biopsies may not always provide the same results as traditional biopsies. This is due to the fact that liquid biopsy samples only contain a small fraction of all cells in the body. Traditional biopsies, on the other hand, can examine all cells from a tissue sample and offer more precise information about a patient’s condition.

Does the Test Help with Patient Outcomes?

Liquid biopsies can help with patient outcomes in a number of ways. For instance, it may allow for earlier detection of disease or provide information that traditional biopsy techniques cannot detect. This could lead to earlier treatment and better management of the disease. Additionally, liquid biopsy tests are non-invasive and require less time than tissue sampling. This means less discomfort for the patient and faster results. Finally, liquid biopsy tests are often much more cost-effective than traditional biopsies.

Overall, liquid biopsy testing can be a highly beneficial tool for medical professionals to use in order to provide better care for their patients and improve overall outcomes.  In addition, the technology is continuing to advance and may improve even more with a little time and research.

Closing, which challenges still exist and need further research, (adhere to more standardization, increasing diversity)

Find out the ways in which liquid biopsy can benefit you and your patients.

Despite the many benefits that liquid biopsy tests have to offer, there are still challenges that exist and need further research. For instance, standards for analysis must be better established in order to ensure consistent accuracy across different labs. Additionally, increasing diversity in testing panels is essential.

Reach out to us to learn more about our capabilities for specimen collections for liquid biopsy discovery and development

BioIVT specializes in control and disease state samples including human and animal tissues or preparations, cell and gene therapy products, blood, and other biofluids, as well as ADME products and contract research services.  Our mission is to enable smarter science and accelerate medical breakthroughs that enhance and extend lives by delivering personalized biospecimen solutions to life science and diagnostic industries.