Liquid biopsy in oncology: a consensus statement of the Spanish Society of Pathology and the Spanish Society of Medical Oncology
- The proportion of cancer patients with tumours that have targetable genomic alterations is increasing, which is crucial for tailored treatment and predicting immunotherapy efficacy.
- Initial tissue biopsies are often inadequate for precision oncology, and obtaining new tumour tissues at progression is technically challenging.
- Liquid biopsy is highlighted as a vital diagnostic alternative, offering dynamic evaluation of tumour genomic profiles and capturing genomic heterogeneity.
- Multiple diagnostic techniques are available for liquid biopsy, each varying in precision and performance.
- The Spanish Society of Pathology and the Spanish Society of Medical Oncology endorse liquid biopsy as a viable alternative to tissue biopsy for biomarker study in various clinical contexts.
- Standardisation of pre-analytical and analytical processes is crucial for reproducibility and to create structured clinical reports.
- It is necessary to establish multidisciplinary tumour molecular boards to guide therapeutic decisions based on the genomic profile.
By the year 2030, 22.2 million new cases of cancer are expected worldwide: a challenge for cancer patient diagnosis and therapeutic approaches. Despite this increase, patient prognosis has improved with a gradual decrease in cancer-related mortality, reflecting the breakthroughs in early diagnosis and cancer therapy. Therapeutic advances are mainly based on the understanding that cancer is a heterogeneous genomic disease . This has boosted the development of new tailored or precision therapeutic approaches that have a positive impact on patient survival.
The proportion of cancer patients with tumours harbouring potentially targetable genomic abnormalities at the start of treatment or during progression has been growing over time. This is the basis for precision medicine, crucial for taking therapeutic decisions and for understanding the therapy-induced dynamic evolution of the tumour . At present, its use is considered standard in daily clinical practice for the treatment of some tumours , because it improves the outcome. At the same time, drug approvals based on molecular abnormalities, regardless of the histology, have been enabled by precision oncology (tumour type-agnostic therapy approvals) . Precision oncology has also helped to obtain information about predictive biomarkers, such as the tumour mutational burden (TMB), related to the efficacy of immune checkpoint inhibitors (ICI) in many cancer types.
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