In 2016, more than 16 million new cancer cases will be diagnosed in the United States and nearly 600,000 people will succumb to the disease, according to the American Cancer Society. What’s more, the Agency for Healthcare Research and Quality estimates that the direct medical costs for cancer in the United States in 2014 were $87.7 billion. In the fight against cancer, both pragmatic and financial components must be considered.
Precision medicine – which directs treatment based on the specific genetic drivers of an individual’s disease – has the potential to transform cancer from a deadly disease into a chronic illness that can be managed over time. By some estimates, the precision medicine market is poised to reach approximately $88 billion by 2023.
Here, Michael Nall, CEO of Biocept, shares how one precision medicine advance, liquid biopsy, could impact cancer care through a simple blood draw.
How It Works
Tissue biopsies are and will remain the gold standard in cancer testing. However, they are highly invasive and expensive surgical procedures that can burden patients physically, emotionally, and financially. For those reasons, liquid biopsies have emerged as effective alternatives to tissue biopsies, and the market is responding. The liquid biopsy market is projected to reach $22 billion by 2020, according to a report by analysts at J.P. Morgan.
To understand the potential of liquid biopsies, it is helpful to remember that cancer is a disease driven by molecular alterations within the malignant tumor. By identifying alterations, physicians can determine therapeutic options and track tumor progression. These alterations are present in the actual tumor tissue, but scientists have also found these mutations in the circulating tumor DNA and circulating tumor cells in a cancer patient’s blood.
Therefore, with a relatively inexpensive and non-invasive blood test, a liquid biopsy can provide the same kinds of information as a tissue biopsy. And through a simple blood test, physicians can now identify biomarkers specific to the patient’s tumor to establish a personalized treatment plan, as well as better determine if a given therapy is working or not. As liquid biopsy technology continues to evolve and becomes further validated in the medical community, physicians are increasingly using it to treat cancer like a chronic illness.
An important opportunity for liquid biopsy is use of the technology to support immunotherapy, which harnesses a patient’s own immune system to attack cancer cells, as opposed to relying on harsh drugs such as chemotherapy. Immunotherapy is a significant innovation, however, not all patients are candidates for this type of treatment, and newer immunotherapies are very expensive. Liquid biopsy tests are an affordable and non-invasive method that can be used to qualify patients for immunotherapy agents and for clinical trials. Biocept’s proprietary blood-based test to determine the status of PD-L1, a key biomarker for immunotherapy, is an example of such a test.
Additionally, given the manner in which immunotherapy attacks tumor cells, a phenomenon called pseudo-progression may be observed, where tumors visually appear to be increasing in size because the original tumor is surrounded by immune cells attacking it. Liquid biopsy tests can provide more clarity in this situation by tracking cancer biomarker counts in the blood, rather than relying on imaging, to provide a more accurate snapshot of the tumor’s response in real time.
The Promising Outlook
In reality, the fight against cancer will be a long battle, but through innovation, dedication, and perseverance, we’re getting closer each day. In just the past two years, oncologists have significantly increased their use of liquid biopsies to treat and monitor cancer.
The liquid biopsy segment is one new piece of the puzzle that is aimed at improving outcomes for the millions of patients diagnosed each year with cancer, as well as the stakeholders working to advance treatment and lower costs for people in need.