Gilles Erb, Global Scientific Director, Integrated Molecular Medicine at Roche, gave an overview of how to target more patients and improve patient outcomes in precision medicine by targeting therapies based on genomic profiling. Erb suggested that integrating data from multiple sources is key for advancing healthcare systems and ensuring better patient care. The healthcare community must provide equity; every patient should have access to diagnostics and treatment care plans.
Erb proposed that offering patients molecular-guided therapies based on genomic profiling is a key benefit for patients. Between 2019 and 2021, the number of biomarker-guided therapies approved in the US and Europe increased. However, in non-small cell lung cancer, the most advanced indication for molecular-guided therapy, there is a significant drop-off in patient access to therapy. From a sample of 1,000 patients only 356 get access to therapy due to issues in the diagnostic path. Challenges in the diagnostic path include tissue availability and the need for alternative options like liquid biopsy to ensure comprehensive testing. Erb explained that genomic profiling is hard without a suitable biopsy.
To overcome the tissue shortage, Erb suggested that a complementary approach to biopsies is a potential way forward: liquid biopsies are minimally invasive procedures that complement tissue biopsies by providing additional insights and improving the diagnostic process. A recent publication showed that combining liquid and tissue profiling identified actionable targets in over 65% of patients. Furthermore, the key advantage of liquid biopsies is that one can draw blood at nearly every stage of the patient journey including the progress of the disease and relapse of the disease. This helps physicians monitor disease progression and informs their treatment decisions for the patients.
The tumour fraction refers to the percentage of circulating tumour DNA in blood and improves the reliability of liquid biopsy results. Adding tumour fractions to liquid biopsy parameters enhances their accuracy. According to Erb a high tumour fraction correlates with high concordance (92%) between tissue and liquid biopsy results, giving researchers more confidence in their results. Therefore, tumour fraction is a critical parameter for interpreting liquid biopsies.
Overall, this combined strategy can improve diagnostic accuracy and help optimise patient management. With it forecasted that liquid biopsies will become more integrated into the patient journey, it is expected that this will contribute to ensuring timely access to molecular-guided therapies. Erb concluded with the following statement: “We need to think about the patient, what makes sense for each single patient, and we need to assess every patient accordingly to what the option are for these patients.”
