Dr. Papadimitrakopoulou on Implications of the NILE Trial in NSCLC

Vassiliki A. Papadimitrakopoulou, MD, professor of medicine, Department of Thoracic Head and Neck Medical Oncology, Division of Cancer Medicine, the University of Texas MD Anderson Cancer Center, discusses the implications of the NILE trial in non—small cell lung cancer (NSCLC).

The NILE trial demonstrated the feasibility of using a liquid biopsy to accurately profile a patient’s tumor. Moreover, the trial demonstrated a faster turnaround time with the Guardant360 next-generation sequencing (NGS) panel as compared with standard tissue-based testing.

Timely testing is important, says Papadimitrakopoulou, adding that frontline treatment decisions should not have to be made without knowing what the patient’s molecular profile is. Because liquid biopsies are not reliant on tumor tissue, patients who would have been otherwise unable to undergo testing can now turn to liquid biopsies as a way of gathering this information.

Despite these data, tissue-based testing is still considered the “gold” standard, adds Papadimitrakopoulou. Although liquid biopsies have made molecular profiling easier, there is still a subset of patients who do not shed enough cell-free DNA (cfDNA) in their bloodstream to undergo cfDNA analysis. This patient subset accounts for 20% to 25% of those with NSCLC, and as such, it is unlikely that tissue profiling will ever become obsolete, concludes Papadimitrakopoulou. Rather, the 2 assays will probably be used in a more complementary fashion in the future.