In recent years, a groundbreaking innovation has been transforming the landscape of cancer diagnosis and treatment in India – liquid biopsies where these non-invasive tests have emerged as a game-changer, offering a less invasive and more accessible approach to cancer detection and monitoring. With a burgeoning population burdened by cancer, especially in India, where cancer is one of the leading causes of mortality, the advent of liquid biopsies holds immense promise in revolutionising cancer care.
In an interview with HT Lifestyle, Dr Salil Patkar, Medical Oncologist at Fortis Hiranandani Hospital in Vashi, shared, “A biopsy is a critical diagnostic procedure in cancer care. It involves the extraction of a small tissue sample from a suspicious area in the body, such as a tumor or abnormal growth. This sample is then examined under a microscope by a pathologist to determine if cancerous cells are present and, if so, to identify the type and stage of cancer. Biopsies help guide treatment decisions, allowing oncologists to choose the most appropriate therapies, such as surgery, chemotherapy, or radiation. They are essential for accurate cancer diagnosis and prognosis, aiding in the development of personalized treatment plans for patients.”
He revealed, “Liquid biopsies have ushered in a new era of cancer care in India, offering hope to countless individuals battling this formidable disease. As a non-invasive, accessible, and dynamic therapeutic tool, liquid biopsies have the potential to transform how cancer is detected, monitored, and treated. With further advancements and collaborative efforts, the impact of liquid biopsies on cancer outcomes in India and across the globe is likely to be profound. As we embrace this innovative approach, the journey toward improved cancer management becomes more attainable, providing renewed hope to patients and healthcare providers alike.”
What are Liquid Biopsies?
Dr Kunjal Patel, Molecular Oncopathologist at Neuberg Centre for Genomic Medicine, explained, “Traditionally, cancer diagnosis relied heavily on tissue biopsies, which involved surgically removing a tissue sample for analysis. However, this procedure can be invasive, risky, and sometimes challenging to perform, particularly in advanced cases or when the tumor is in a hard-to-reach location. Liquid biopsies, on the other hand, offer a minimally invasive alternative by analyzing cancer-related genetic material released into the bloodstream, such as circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), extracellular vesicles and microRNAs. These biomarkers provide valuable insights into the presence, progression, and genetic characteristics of cancer.”
Impact on Cancer Detection and Monitoring
Asserting that liquid biopsies have brought about a paradigm shift in cancer monitoring, Dr Kunjal Patel said, “Liquid biopsies are particularly valuable in tracking the disease’s progression, assessing treatment effectiveness, and detecting the emergence of drug resistance. Regular monitoring through liquid biopsies provides a dynamic picture of the tumor’s genetic makeup, facilitating personalised treatment adjustments tailored to the patient’s unique genomic profile.”
Advantages for Cancer Patients in India
Dr Kunjal Patel highlighted, “These tests can significantly reduce the need for invasive procedures and alleviate the burden on healthcare facilities, allowing more patients to benefit from advanced cancer diagnostics. With a simple blood draw, patients can receive accurate and timely information about their cancer status without the need for extensive travel or hospitalization in certain types of cancer. A ctDNA-guided approach to the treatment of stage II colon cancer reduced adjuvant chemotherapy use without compromising recurrence-free survival. The most groundbreaking advancement still lies in the collection of blood within cell-free tubes from remote areas in India, enabling convenient transport to referral centers without any compromise on the quality of the tests.”
Overcoming Challenges
While the potential of liquid biopsies is undeniable, challenges persist and Dr Kunjal Patel said, “One notable concern is the cost of these tests, which can be relatively high. However, as technology advances and demand increases, the costs are expected to decrease, making liquid biopsies more accessible to a broader range of patients. Additionally, the need for specialized equipment and skilled technicians to perform the tests could pose a challenge in resource-constrained areas.”
He added, “CtDNA levels in patients with early stage disease are usually lower than those in patients with metastatic disease, which poses substantial challenges for the use of ctDNA surveillance to detect early relapse. Collaborative efforts between healthcare providers, researchers, and policymakers are essential to address these challenges and ensure equitable access to this transformative technology.”
Future Directions and Promising Research
Dr Kunjal Patel concluded, “The field of liquid biopsies is evolving rapidly, with ongoing research focused on refining the accuracy and scope of these tests. Researchers are exploring the potential of liquid biopsies not only for cancer detection but also for predicting treatment response, monitoring minimal residual disease, and detecting cancer recurrence at an early stage. The integration of artificial intelligence and machine learning algorithms to analyse the vast amount of genomic data including methylation profiles generated by liquid biopsies holds great potential for enhancing the accuracy and clinical utility of these tests.”
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