What is it?
Liquid biopsies detect tumor biomarkers in blood or other bodily fluids, such as urine and saliva, rather than in solid tissue samples. These tests most commonly detect circulating tumor DNA (ctDNA), but some also look at circulating tumor cells (CTCs), exosomes, or other biomarkers. Liquid biopsies have three main applications:
1. Treatment selection: Molecular profiling of tumor biomarkers to identify actionable mutations and match patients to appropriate therapies
2. Early cancer detection: Screening for individual cancer types or multiple cancers at once
3. Disease monitoring: Identifying molecular markers of treatment response and resistance, disease progression, and recurrence—most commonly minimal residual disease (MRD)
While the use of liquid biopsies for treatment selection is becoming more common, liquid biopsies for early cancer detection and disease monitoring are just now starting to be used in the clinical setting.
Why is it useful?
Liquid biopsies for early cancer detection and disease monitoring present several advantages for both patients and providers.
When it comes to cancer detection, primary and specialty care providers can use liquid biopsies to screen for many more types of cancer than traditional forms of cancer screening. These tests can be more convenient and less invasive for patients. They have the potential to detect cancer earlier, when it is more easily treatable and survival rates are higher. In doing so, they may also decrease cancer patients’ total cost of care.
Liquid biopsies for disease monitoring can help oncologists identify signs of treatment response and resistance as well as monitor for early signals of recurrence. Because they are non-invasive, liquid biopsies can be taken serially, allowing for more frequent biopsies with decreased risk of complication and a better patient experience. They also tend to have shorter turnaround times than tissue biopsies, enabling providers to quickly alter treatment plans based on test results. Liquid biopsies for disease monitoring can be especially useful in cases when there’s not enough tumor tissue for a traditional tumor biopsy or when cancer patients are not medically fit to undergo invasive tissue biopsy.
Who are the key players?
Companies with commercial liquid biopsies for early cancer detection
- Arquer Diagnostics
- Exact Sciences
- Pacific Edge
- StageZero Life Sciences
Select companies with tests in development: Burning Rock Biotech, Delfi Diagnostics, Freenome, Guardant Health, Singlera Genomics
Companies with commercial liquid biopsies for disease monitoring
- Adaptive Biotechnologies
- Clinical Genomics
- Guardant Health
Select companies with tests in development: Biovica, Exact Sciences, Foresight Diagnostics, Inivata, Invitae