Liquid Biopsy in Colorectal Cancer: Real-Time Monitoring and Precision Treatment

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• What is Liquid Biopsy?
• Monitoring Tumor Load and Response
• Molecular Changes Under Treatment
• Advantages Over Tissue Biopsy
• Clinical Implementation and Challenges
• Future of Personalized Therapy
• Full Transcript

What is Liquid Biopsy?

Liquid biopsy is a revolutionary diagnostic method for colorectal cancer. It involves analyzing circulating tumor DNA (ctDNA) and RNA from a patient's peripheral blood sample. Dr. Hans-Joachim Schmoll, MD, describes how automated molecular analyzers process this genetic material. This technology provides a non-invasive window into the tumor's biology.

The process allows for frequent monitoring, with tests possible every four weeks. Dr. Anton Titov, MD, highlights its role as a new model for cancer monitoring. It moves treatment from a static snapshot to a dynamic process.

Monitoring Tumor Load and Response

Liquid biopsy enables clinicians to see the tumor load in real time. By measuring the amount of colon cancer genetic material in the blood, doctors can gauge disease burden. This offers a more immediate assessment than waiting for imaging results like X-rays or MRI.

Dr. Hans-Joachim Schmoll, MD, confirms that tumor response is traditionally monitored by radiology. However, liquid biopsy provides a complementary and often more precise measure of treatment effectiveness. It allows for observation of how the tumor behaves under chemotherapy pressure.

Molecular Changes Under Treatment

A key benefit of liquid biopsy is tracking the molecular evolution of a tumor. Chemotherapy can select for resistant cancer cell clones, altering the tumor's genetic profile. Dr. Anton Titov, MD, discusses how this method reveals these changes as they happen.

Dr. Hans-Joachim Schmoll, MD, explains that this is crucial after first-line treatment or during experimental therapy. Seeing these molecular shifts can predict which chemotherapy combination might be effective next. This dynamic profiling is foundational for adaptive therapy strategies.

Advantages Over Tissue Biopsy

Liquid biopsy presents significant advantages over traditional tissue biopsy. It is a simple blood draw, eliminating the need for invasive surgical procedures. This is especially important for monitoring metastatic disease in organs like the liver.

Dr. Hans-Joachim Schmoll, MD, notes it is difficult to repeatedly biopsy a liver metastasis. Liquid biopsy circumvents this risk and discomfort entirely. The technology is available; its broader adoption is now a matter of clinical and economic integration.

Clinical Implementation and Challenges

The implementation of liquid biopsy in routine oncology practice is underway through major international projects. Dr. Hans-Joachim Schmoll, MD, is involved in a large, expensive project focused on colon cancer. These efforts are crucial for validating the clinical utility of ctDNA monitoring.

The primary challenge is not technological but economic. Integrating frequent liquid biopsy testing into healthcare systems requires demonstrating cost-effectiveness. Despite this, the medical community is excited about its potential to improve patient outcomes.

Future of Personalized Therapy

Liquid biopsy is paving the way for a new era of personalized cancer treatment. It helps in selecting therapies based on the real-time genetic makeup of a tumor. Dr. Anton Titov, MD, emphasizes its role in discovering new colon cancer treatments.

Dr. Hans-Joachim Schmoll, MD, describes it as a critical tool for personalized therapy selection and monitoring. By observing changes under treatment, oncologists can make more informed, timely decisions. This approach is set to become a standard model for managing advanced colorectal cancer and other malignancies.

Full Transcript

Dr. Anton Titov, MD: Liquid biopsy in colon cancer or rectal cancer allows monitoring of treatment in real time. What is liquid biopsy? How can it help guide chemotherapy selection for colorectal cancer patients? How does tumor behavior change under chemotherapy?

There is a lot of experience with using automated molecular analyzers for liquid biopsy in colorectal cancer.

Dr. Hans-Joachim Schmoll, MD: Colon cancer DNA and RNA in the peripheral blood of patients can be rapidly analyzed every four weeks by liquid biopsy. By doing liquid biopsy, we see the tumor load. We measure colon cancer genetic material in the patient's blood using automated molecular analyzers. We can also see the changes in the molecular biology of the tumor under chemotherapy treatment. Tumor changes after first-line treatment or experimental therapy.

Dr. Anton Titov, MD: Liquid biopsy can show us tumor molecular changes. It is a new method to monitor the molecular tumor profile regularly during treatment. It is a model for many cancers to start monitoring from early treatment. You monitor the tumor response to chemotherapy in real time by liquid biopsy.

Dr. Hans-Joachim Schmoll, MD: Correct. Tumor response will be monitored by X-rays, MRI, and so on. But liquid biopsy allows more precise monitoring than regular biopsy. It is difficult to stick the patient in the liver all the time to biopsy metastatic colon cancer tumor. We can monitor the tumor just by doing liquid biopsy. The technology is there. It is a question of economics.

Liquid biopsy monitoring of colon cancer tumor is part of a very expensive international project on colon cancer. The project is running now. We are very excited about liquid biopsy.

Dr. Anton Titov, MD: It is a new method to discover new colon cancer treatments. Liquid biopsy in personalized therapy selection and monitoring helps to observe changes in colon cancer tumor under treatment. Liquid biopsy detects and monitors cancer in high-risk patients with stage 4 metastatic and advanced colorectal cancer. Colon cancer biopsy results can predict the next chemotherapy combination in colon cancer treatment. Liquid biopsy can show the changes in the molecular biology of the tumor under chemotherapy treatment.

A leading colorectal cancer expert discusses tumor monitoring by liquid biopsy.