Although tissue biopsy still remains the gold standard for molecular profiling, it is beset by inherent limitations. Sample acquisition can be an invasive procedure and is sometimes not possible depending on where the tumour is located in the body. If a tissue can be acquired, next generation sequencing often fails due to an inadequate amount of tumour tissue on the sample. The sequencing of the tissue itself can take weeks at a time, and when the sample has been sequenced, the results may not be representative of intratumoral or temporal heterogeneity.
Liquid biopsy on the other hand needs far less sample and can be collected far easier than solid tissue. Consequently, turnaround time is usually seven to ten days rather than weeks. Furthermore, one of the greatest advantages of liquid biopsy is also the ability to capture a patient’s status over time, monitoring for relapse and guiding treatment.
Why then is liquid biopsy so difficult to implement in the clinic? Pinzani outlined some of the weaknesses that come with the technology. First and foremost was the need to choose the right integrated workflow for the specific application. Readymade solutions for liquid biopsy are hard to come by and so each lab will need to perform validation themselves.
Furthermore, knowledge of the field is still developing and dedicated, specialised personnel are scarce. Downstream of this, the dialogue between laboratories and clinics also needs to be developed to establish solid networks and protocols. Lastly, cost-effectiveness and reimbursement which might limit the approach also need to be evaluated.
Pinzani’s presentation then went on to address the work that her team has undertaken to accelerate the adoption of liquid biopsies. She concluded by discussing potential for the technology to evolve in early disease detection and monitoring, emphasising the importance of continuous development and adaptation in clinical practices.
