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Article

Towards Routine Implementation of Liquid Biopsies in Cancer Management: It Is Always Too Early, until Suddenly It Is Too Late

1
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne Centre for Cancer Research, Parkville, VIC 3000, Australia
2
Centre for Health Policy, Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Population and Global Health, Parkville, VIC 3053, Australia
3
Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC 3000, Australia
4
Victorian Comprehensive Cancer Centre, Parkville, VIC 3050, Australia
5
Illumina Inc., San Diego, CA 92122, USA
6
Department of Pathology, Peter MacCallum Cancer Centre, Parkville, VIC 3000, Australia
7
Division of Personalised Oncology, Walter and Eliza Hall Research Institute, Melbourne, VIC 3052, Australia
8
Department of Medical Oncology, Northern Health, Epping, VIC 3076, Australia
9
Department of Surgery, St. Vincents Hospital, Melbourne, VIC 3065, Australia
10
Department of Medical Oncology, Western Health, St. Albans, VIC 3021, Australia
*
Author to whom correspondence should be addressed.
Joint last author.
Diagnostics 2021, 11(1), 103; https://doi.org/10.3390/diagnostics11010103
Received: 20 December 2020 / Revised: 4 January 2021 / Accepted: 5 January 2021 / Published: 11 January 2021
Blood-based liquid biopsies are considered a new and promising diagnostic and monitoring tool for cancer. As liquid biopsies only require a blood draw, they are non-invasive, potentially more rapid and assumed to be a less costly alternative to genomic analysis of tissue biopsies. A multi-disciplinary workshop (n = 98 registrations) was organized to discuss routine implementation of liquid biopsies in cancer management. Real-time polls were used to engage with experts’ about the current evidence of clinical utility and the barriers to implementation of liquid biopsies. Clinical, laboratory and health economics presentations were given to illustrate the opportunities and current levels of evidence, followed by three moderated break-out sessions to discuss applications. The workshop concluded that tumor-informed assays using next-generation sequencing (NGS) or PCR-based genotyping assays will most likely provide better clinical utility than tumor-agnostic assays, yet at a higher cost. For routine application, it will be essential to determine clinical utility, to define the minimum quality standards and performance of testing platforms and to ensure their use is integrated into current clinical workflows including how they complement tissue biopsies and imaging. Early health economic models may help identifying the most viable application of liquid biopsies. Alternative funding models for the translation of complex molecular diagnostics, such as liquid biopsies, may also be explored if clinical utility has been demonstrated and when their use is recommended in multi-disciplinary consensus guidelines. View Full-Text
Keywords: liquid biopsy; ctDNA; CTC; genomics; cancer; minimal residual disease; health services research; biomarkers; health economics; early detection; cancer surveillance liquid biopsy; ctDNA; CTC; genomics; cancer; minimal residual disease; health services research; biomarkers; health economics; early detection; cancer surveillance
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MDPI and ACS Style

IJzerman, M.J.; de Boer, J.; Azad, A.; Degeling, K.; Geoghegan, J.; Hewitt, C.; Hollande, F.; Lee, B.; To, Y.H.; Tothill, R.W.; Wright, G.; Tie, J.; Dawson, S.-J. Towards Routine Implementation of Liquid Biopsies in Cancer Management: It Is Always Too Early, until Suddenly It Is Too Late. Diagnostics 2021, 11, 103. https://doi.org/10.3390/diagnostics11010103

AMA Style

IJzerman MJ, de Boer J, Azad A, Degeling K, Geoghegan J, Hewitt C, Hollande F, Lee B, To YH, Tothill RW, Wright G, Tie J, Dawson S-J. Towards Routine Implementation of Liquid Biopsies in Cancer Management: It Is Always Too Early, until Suddenly It Is Too Late. Diagnostics. 2021; 11(1):103. https://doi.org/10.3390/diagnostics11010103

Chicago/Turabian Style

IJzerman, Maarten J., Jasper de Boer, Arun Azad, Koen Degeling, Joel Geoghegan, Chelsee Hewitt, Frédéric Hollande, Belinda Lee, Yat H. To, Richard W. Tothill, Gavin Wright, Jeanne Tie, and Sarah-Jane Dawson. 2021. "Towards Routine Implementation of Liquid Biopsies in Cancer Management: It Is Always Too Early, until Suddenly It Is Too Late" Diagnostics 11, no. 1: 103. https://doi.org/10.3390/diagnostics11010103

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