Dr. Sparano on Improving Liquid Biopsies in Breast Cancer

Joseph A. Sparano, MD, associate director for clinical research, Albert Einstein Cancer Center, Montefiore Medical Center, discusses ways to improve the clinical utility of liquid biopsies in breast cancer.

Currently, liquid biopsies are not utilized as much in breast cancer as they are in other solid tumors, says Sparano. In order to improve the clinical utility of this modality, it needs broader application and study as well as the identification of more effective therapies that are linked with a specific biomarker. An example of this is patients with HER2-positive disease responding to anti-HER2—directed therapy such as trastuzumab (Herceptin) and pertuzumab (Perjeta). But researchers need more examples like this, he notes.

Ideally, Sparano adds, a liquid biopsy panel will include a range of targetable mutations and will be able to tell a patient which corresponding therapy they will best respond to. The greater the sum of alterations and therapies, the more likely a liquid biopsy will have clinical utility.

Another potential application for this technology is in the surveillance of patients who are at a high risk for recurrence and using that biomarker to direct therapy to prevent development of metastasis. The FDA has recently recognized metastasis-free survival as a crucial regulatory endpoint to support the approval of a drug.