Augusto Villanueva, MD, PhD, assistant professor, Icahn School of Medicine, discusses remaining challenges with liquid biopsies in hepatocellular carcinoma (HCC).

The first issue lies in the technology itself, Villanueva says. There have been recent studies suggesting that circulating tumor DNA (ctDNA) can be technologically challenging to detect, and this is something oncologists have to address. Researchers know ctDNA is present, but the tools they currently utilize require more development. Villanueva says there needs to be a “huge effort” in terms of improving and standardizing the techniques of liquid biopsies.

The second challenge is that more data are needed to indicate that liquid biopsies actually improve outcomes for patients in the long run. More biomarkers are needed to predict a patient’s response to a certain therapy. Liquid biopsies can help oncologists understand the tumor profile, but that still isn’t a guarantee that treatment will be effective. The promise of liquid biopsies is there, but the potentially practice-changing nature of this technology remains to be seen.

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Augusto Villanueva, MD, PhD, assistant professor, Icahn School of Medicine, discusses remaining challenges with liquid biopsies in hepatocellular carcinoma.

Dr. Villanueva on Challenges For Liquid Biopsies in HCC

Augusto Villanueva, MD, PhD, assistant professor, Icahn School of Medicine, discusses the potential of liquid biopsy to improve treatment for patients with hepatocellular carcinoma (HCC).

Most patients are diagnosed with HCC on the basis of imaging. Therefore, few tissue samples are available for testing, explains Villanueva. Liquid biopsy relies on molecular data from tumor components, mainly cell-free nucleic acids and circulating tumor cells, that are released into the bloodstream and are potential biomarkers for HCC.

Liquid biopsy could be useful to assist in the surveillance of patients at high risk for development of HCC so that these patients can be given curative therapies, but it could also eventually help identify which patients are candidates to receive specific systemic therapies.

Currently, no biomarkers are available to help guide clinical decision making; however, liquid biopsy could eventually help correlate specific mutations in a patient's DNA with the most appropriate systemic treatment for their disease and cancer stage.

View more from the 2018 International Liver Cancer Association Annual Conference 

Augusto Villanueva, MD, PhD

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Dr. Villanueva on Challenges For Liquid Biopsies in HCC

Dr. Villanueva on Liquid Biopsy for HCC