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 tumors having potentially targetable genomic alterations is increasing.
- Diagnosing these alterations can lead to tailored treatments and provide additional predictive information on immunotherapy efficacy.
- In many cases, initial tissue biopsies are inadequate, and obtaining new tissue specimens at progression is challenging.
- Liquid biopsy is an efficient diagnostic alternative that allows dynamic evaluation of the tumor genomic profile and captures genomic heterogeneity within patients.
- Several diagnostic techniques for liquid biopsy exist, each with varying precision and performance.
- The Spanish Society of Pathology and the Spanish Society of Medical Oncology have evaluated liquid biopsy methods for cancer patients.
- Liquid biopsy is considered a viable alternative to tissue biopsy for biomarker study in various clinical settings.
- Standardizing pre-analytical and analytical procedures is important for reproducibility and for generating structured clinical reports.
- Multidisciplinary tumor molecular boards should oversee these processes to enable the most suitable therapeutic decisions according to 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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