Liquid biopsies, which can detect cancer cells and DNA in the bloodstream, have shown promise in treating metastatic breast cancer. A new study published in The New England Journal of Medicine found that using liquid biopsies earlier could give patients more time without symptoms and potentially extend their lifespan.
Study Overview
- The study followed 315 patients with hormone receptor-positive (HR+) metastatic breast cancer.
- Researchers used liquid biopsies to identify genetic mutations that make certain treatments less effective.
- Patients who received either a hormonal drug or an experimental medication called camizestrant based on the results of their liquid biopsy test saw significant improvements in disease control and quality of life compared to those who stayed on hormonal therapy alone.
Key Findings
- Those who switched to camizestrant experienced better outcomes than those who continued with hormonal therapy.
- Dr. Jennifer Litton, a medical oncologist at MD Anderson Cancer Center, stated, "The findings suggest that using liquid biopsies earlier could give patients more time without symptoms and potentially extend their lifespan."
Current Applications and Future Research
Liquid biopsies have already proven useful for monitoring colon cancer patients after surgery, according to Dr. David Rimm, a pathologist at Yale University School of Medicine. Researchers are also exploring ways to use them for screening healthy individuals for various types of cancers.
Expert Opinions
- Some experts caution that the technology is still evolving and not yet widely available outside clinical trials or academic centers.
- Dr. Susan Domchek, director of precision medicine at Penn Medicine’s Abramson Cancer Center, emphasized the need for more research: "We’re not there yet. We need more research before we can say this is something we should be doing broadly."
- Dr. Litton agreed, stating, "It’s not ready for prime time yet."
Optimism for the Future
Despite these limitations, researchers are optimistic about the potential benefits of liquid biopsies in treating metastatic breast cancer. Dr. Litton remarked, "This is an exciting area. We’re going to see big changes coming down the pike."
Importance of Ongoing Research
The study also highlights the importance of ongoing research into new treatments for HR+ metastatic breast cancer. The National Institutes of Health has awarded $1 million grants over five years each to researchers at MD Anderson Cancer Center and Yale University School of Medicine to determine whether liquid biopsies should become a standard part of treatment for HR+ metastatic breast cancer patients.
Current Treatments and Challenges
In the meantime, the FDA has approved several drugs specifically designed to target genetic mutations in tumors, such as CDK4/6 inhibitors like palbociclib and ribociclib. These drugs work by blocking proteins involved in cell division and growth, and they have been shown to pause tumor growth in many women with HR+ metastatic breast cancer. However, their effectiveness varies throughout the body, and they may not work as well against tumors with specific genetic mutations.
Resistance to Treatment
- Dr. Litton noted that some women may develop resistance to treatment over time.
- Dr. Domchek pointed out that while CDK4/6 inhibitors are effective against most tumors, studies have shown that about 10% to 20% of tumors will develop resistance within two years or less.
Liquid Biopsy-Guided Therapy
Switching treatment based on liquid biopsy results, called liquid biopsy-guided therapy, could help overcome these challenges by identifying genetic mutations associated with resistance before it develops. It could also help doctors choose between different medications based on what works best against specific mutations.
Funding and Disclosure
The study was funded by Pfizer Inc. and Novartis Pharmaceuticals Corp., which manufacture camizestrant and similar medications, respectively. Pfizer Inc. also provided funding for other studies related to camizestrant. Neither company played any role in designing or conducting the study, nor did they review the manuscript before its publication.
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