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Liquid Biopsies a Quicker Alternative to Standard Approaches in NSCLC

Danielle Bucco
Published: Monday, Jan 01, 2018

Jared Weiss, MD
Jared Weiss, MD
Liquid biopsies offer an alternative method for detecting molecular mutations in patients with non–small cell lung cancer (NSCLC), according to expert Jared Weiss, MD.

on Advanced Non–Small Cell Lung Cancer, Weiss, an assistant professor at the UNC Lineberger Comprehensive Cancer Center, discussed utilizing liquid biopsies for patients with lung cancer, the pros and cons of the approach, and when it might be appropriate to rebiopsy patients.

OncLive: When is it appropriate to use a liquid biopsy?

Weiss: Molecular information has become key to optimal treatment of patients with stage IV NSCLC. When we match the target with targeted therapy, we get treatments that are less toxic, more effective, and demedicalize the life of the patient because they are oral and not intravenous. This makes them highly desirable.

If a patient has positive results, it has been well established that you can [act on] it. A patient can go on the 1 FDA-approved drug, osimertinib (Tagrisso), with expected outcomes that we know are superior to chemotherapy. In contrast, if you do not find T790M, then a tissue biopsy is appropriate. This can be useful to look for T790M and other mechanisms of resistance that may be actionable.

What are the advantages and disadvantages of liquid biopsies? 

Tissue and blood offer distinct advantages and disadvantages. Pre-analytical variables are particularly important for liquid biopsies beyond the scope of our conversation and need to be paid attention to.

With tissue biopsy, the advantages are greater sensitivity for the spot where you put the needle. However, a disadvantage is that you must put a needle into a patient. There are risks, discomforts, and time delays associated with tissue biopsy. Additionally, there can be heterogeneity both within a tumor and within different locations. A tissue biopsy only tells you about where you put the needle.

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