Brian D. Crompton, MD, physician, Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, assistant professor of pediatrics, Harvard Medical School, discusses the potential of liquid biopsies in the treatment of pediatric patients with sarcoma.

Currently, circulating tumor DNA (ctDNA) and genomic profiling are done in pediatric patients with sarcoma via tissue biopsies. Although this standard is sufficient, it is limited to the part of the body in which the tissue is taken from. In pediatric sarcoma, ctDNA can release tumor cells into the bloodstream, making liquid biopsy a potentially superior method of detection. This method has not been proven to work yet, Crompton says, but if it is confirmed to be effective, liquid biopsies may allow for easier enrollment on clinical trials. It might even bypass the need for patients with recurring disease to get a surgical procedure to verify the presence of disease.

Although these answers are about 5 years down the road, 5 years ago the idea of a liquid biopsy was thought to be impossible, Crompton says. The explosion of technology and new techniques that are available to scientists all over the world now makes this an exciting time in pediatric sarcoma, he concludes.

Videos

Brian D. Crompton, MD, physician, Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, assistant professor of pediatrics, Harvard Medical School, discusses the potential of liquid biopsies in the treatment of pediatric patients with sarcoma.
 

Dr. Crompton on the Potential for Liquid Biopsies in Pediatric Sarcomas

Brian D. Crompton, MD, physician, Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, assistant professor of pediatrics, Harvard Medical School, discusses the challenges associated with implementing liquid biopsies in pediatric sarcoma.

One of the hurdles in trying to implement any new treatment or testing strategy into clinical practice is ensuring its clinical utility, explains Crompton. Crompton notes that liquid biopsies are not dangerous—a simple blood draw is all that is needed and is minimally invasive. However, a liquid biopsy requires a little extra work and time on the part of the physician. There needs to be some incentive to get them on board with this emerging strategy, Crompton says.

Liquid biopsies will help researchers understand the disease better, particularly with regard to detecting circulating tumor DNA. As this practice becomes more widespread, guidelines for sample collection will be put in place. Crompton adds that Dana-Farber Cancer Institute is involved with about 12 clinical trials modifying liquid biopsies.

Dr. Crompton on Challenges With Liquid Biopsies in Pediatric Sarcoma

Brian D. Crompton, MD, physician, Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, assistant professor of pediatrics, Harvard Medical School, discusses the utilization of liquid biopsies in pediatric patients with sarcoma.

Pediatric tumors release circulating tumor DNA, as well as circulating tumor cells in some cases. If these samples are selected by a blood draw, a liquid biopsy can identify the circulating tumor DNA by detecting the mutations that are present in the tumor. Crompton says that this will help clinicians better understand the mutation pattern in patients who have multiple sites of disease.

It is important to understand the mutational spectrum across all the tumors in a patient with multiple sites of disease, Crompton explains, but a tissue biopsy only provides information on the particular spot sampled. There might not be targetable mutations in the chosen tissue biopsy site, so clinicians can miss an opportunity to integrate treatment, or they may only administer a treatment that targets that one tumor, missing the other sites completely. With a liquid biopsy, information from the circulating tumor DNA may have the potential to guide treatment.

Brian D. Crompton, MD, physician, Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, assistant professor of pediatrics, Harvard Medical School, discusses the utilization of liquid biopsies in pediatric patients with sarcoma.
 

Brian D. Crompton, MD

Articles

Dr. Crompton on the Potential for Liquid Biopsies in Pediatric Sarcomas

Dr. Crompton on Challenges With Liquid Biopsies in Pediatric Sarcoma

Dr. Crompton Discusses Liquid Biopsies in Pediatric Sarcoma