Page 16 - January 2021 South Florida Hospital News
P. 16
ONCOLOGY UPDATE in South Florida
Liquid Biopsies: Endless Possibilities
on Cancer’s New Frontier
We congratulate our
For more than 40 years, This approach, available in
colleagues on their
oncologists prescribed several platforms, is commer-
“empiric” chemotherapy cially viable for cancer care
for cancer patients, using and recently approved for
appointments
their experience and reimbursement by the
instincts to search for the Centers for Medicaid and
right combination of drugs Medicare Services (CMS). At
Jorge Galvez Silva, M.D., to kill or, at least, prevent the Memorial Cancer
further multiplication of Institute (www.mhs.net/ser-
Director, and cancer cells. This was the vices/cancer), we’re having
Ossama M. Maher, M.D., norm given the absence of success using liquid biopsies
a more precise understand- BY LUIS E. RAEZ, MD, to diagnose and evaluate new
Associate Director of the ing of the specific makeup FACP, FCCP cancer patients, especially
of tumors. those with lung cancer, where
Blood & Bone Marrow Transplant Center we’ve identified nine genes
The Present that are known to cause the disease. We
at Nicklaus Children’s Hospital. Today, thanks to genetic analysis of have targeted treatments for each and can
tumors, we’re able to identify the genes personalize therapy per patient.
responsible for the oncogenesis and spread Maria, a 41-year-old stage IV lung can-
of a tumor and can be more targeted in our cer patient, is someone who recently ben-
K K I I Z Z through next generation sequencing no warning signs for lung cancer, she, like
efited from this technology. Since there are
treatment. Until now, what we learned
60% of the lung cancer patients we see,
(NGS, a survey of the genome in search of
anomalies), the most widely used technol-
presented to us at a later stage. Her liquid
ogy, was sometimes hampered by not hav-
ing enough tumor tissue required to per- biopsy uncovered an ALK fusion, which
told us the best treatment for her cancer
form the genetic analysis. Additionally, would be to receive an oral agent, which
Medical with tumors being heterogeneous, differ- was successful, instead of palliative and
empiric chemotherapy. She responded
ent areas of a suspicious solid mass could
contain more cancer cells than others,
even within the same sample or when well to targeted therapy, didn’t need fur-
ther chemotherapy, and said, “I’m still
5955 Ponce de Leon Blvd., Coral Gables, FL 33146 comparing several samples from the same young, have a wonderful family, a wonder-
patient. ful life, and am confident the research is
going to give me many more years."
A Better Way
Tumors release DNA into the blood- What’s Next?
stream that can be collected via a blood The possibilities with liquid biopsies are
e
o
T h e A nd e rson F a l i m y C a nc r I e t u t i t s n test, separated from the plasma, and stud- endless. In the future, we are hopeful they
ied. The circulating tumor DNA (ctDNA) can be used to predict recurrences of can-
and intact circulating tumor cells (CTCs) cer in patients who have had surgery.
are two of the targeted components during Taking its potential a step further, it’s pos-
what is known as a “liquid biopsy.” sible we could diagnose cancer through
While we’ve been able to extract DNA blood testing that would identify DNA
from identified tumor cells and study its alterations. This early-stage diagnosis
molecular makeup since the 1980s, we could happen even before the patient
haven’t been able to combine that with experiences symptoms or gets radiology
NGS until now. This is a quantum leap in findings. It wouldn’t be surprising if liquid
our field, resulting in the delivery of criti- biopsies completely replace tissue biopsy
cal information within two weeks (as at some point in the not-too-distant
opposed to the four or five required for tis- future.
A t J u e t i p r M e a c i d l C e r e t n r w e t k a e a m r a n i l p i c s i d i t l u y a p r p ao c h t sue analysis) that isn’t affected by tumor
C e c n a r p e i t a t n s h ave a e c c s e s t o s o m e o f t h e m s o t r e n o w n ed p s y h heterogeneity. Dr. Luis Raez is chief scientific officer and
h t e fi l e d a n d t h e m s o t a dv v na e c d t h c e n o l o g y i n t h e r e o i g n . uO r e x l The offshoot of all this is that we can medical director at the Memorial Cancer
y t p s e of a c f nc er i , nc l udi ng omc x e l p a nd ad a v nc e d s t ag , s e w htiw s p
i n b t s a e r , l u n g , g n y o l o c e g , gci g l a n i t s e t n i o r t s a , p c i t a e r c n a , a d ln i ve now use liquid biopsies and NGS to eval- Institute, part of the Hollywood-based
uate patients at several different points of Memorial Health Care System. He is board
A t t h e A n d o s r e n F a m l i y C na e c r I e t u t i t s n , yo l u’ l h ave t h e f e l oe f a their cancer treatment, making adjust- certified in internal medicine and medical
h a t i p s o l b e k c a d by t h e e x ep s i t r e a n d t h c e n o l o g y r n i l a v i g t a to f ments in their chemotherapy based on oncology and board eligible in hematology. Dr.
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develop targeted agents to kill specific can- International University’s Herbert Wertheim
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tive, curing some patients and potentially president of the Florida Society of Clinical
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improving the quality of life for all. Oncology (FLASCO).
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16 January 2021 southfloridahospitalnews.com South Florida Hospital News
