Dr. Kasi Discusses Role of Liquid Biopsies in CRC

Pashtoon M. Kasi, MD, MBBS, MS, assistant professor of oncology, senior associate consultant, Division of Hematology/Oncology, Mayo Clinic, discusses the role of liquid biopsies in the treatment of patients with colorectal cancer (CRC).

Liquid biopsies, in terms of detecting circulating tumor DNA, have rapidly made their way into research in recent years and they are now starting to make their way into practice. The most recent guidelines on their use came from the 2018 ASCO Annual Meeting, but they are not quite ready for primetime, Kasi says. Currently, the only FDA approved indication for liquid biopsies is in the lung cancer space.

If you look at the recent data that have come out on liquid biopsies, however, there is great deal of enthusiasm behind this approach due to its specificity and sensitivity. For early-stage disease, the role of liquid biopsies is still not well-defined. In the metastatic setting, however, liquid biopsies are able to detect important biomarkers such as HER2, BRAF, and RAS. These genetic alterations can then be paired with effective targeted therapies.

Importantly, liquid biopsies are particularly helpful when tissue biopsies are not available, adds Kasi. Although liquid biopsies are not meant to replace this gold standard, the 2 modalities can be used in adjunct of each other.