How can liquid biopsy manage my father’s pancreatic cancer?

Question

Hello doctor,

My father was recently diagnosed with pancreatic cancer. I am trying to understand his treatment options and the role that liquid biopsy could play. Can you explain how liquid biopsy works for pancreatic cancer and how it might be used to monitor his disease or guide his treatment plan?

I am specifically curious about, How accurate and reliable are liquid biopsies compared to tumor tissue samples for pancreatic cancer. If my father undergoes a liquid biopsy, what types of biomarkers or genetic information might it uncover that could impact his treatment approach? How frequently would a liquid biopsy need to be done to monitor his pancreatic cancer over time?

I want to make sure my father receives the best possible care, so any insights you can provide on how liquid biopsy fits into the management of pancreatic cancer would be greatly appreciated.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

The liquid biopsy concept is based on the observation that tumors shed evidence of their existence in the bloodstream. This evidence can be the tumor cells themselves, their DNA and RNA, or their proteins. Tumor cells grow aberrantly and die at a high rate and thus shed a fair amount of material into the blood.

Tumor cells can be used for liquid biopsies, but cells are hard to extract and analyze. DNA and proteins are fairly stable, and the technology to analyze them is very advanced. CellSEEK applies these technologies to detect DNA alterations that are common in tumors and also to detect proteins that are commonly produced by cancer cells. No single one of these markers has much diagnostic value alone, but combined, they are highly accurate and rich in information.

The key technological advance in this paper is to improve the accuracy of detection of cancerous DNA mutations while maintaining high sensitivity. This technique was combined with a systematic search through a set of cancer biomarker proteins to identify DNA-protein “signatures” that indicate cancer. And they did this work on a large and carefully characterized set of patients and healthy controls.

The result is that not only can CancerSEEK detect many types of cancer with high sensitivity, but it can also do so with very, very few false positives. This last feature is incredibly important. Most people do not have cancer, so even a two percent false-positive rate will lead to more false positives than true positives. The CancerSEEK false positive rate is 0.9 percent.

What is even more impressive and qualifies this work as a breakthrough is that the test works well on several cancers for which there are currently no screening tests available. Ovarian, liver, and pancreatic cancers are typically not detected until very late stages when they are essentially untreatable. We may well already have good treatments for these cancers in their early stages, but we have never even tested them because we cannot identify patients early enough to give them a try.

This is possibly the biggest single advance ever in cancer diagnostics. The scope and the execution of the work are simply outstanding. I expect this test to get better, and I expect it to become a routine part of healthcare in the next decade. This is what an actual breakthrough looks like.

I hope I have answered your question.