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Highlighting the Clinical Utility of Liquid Biopsies for Biomarker Detection in NSCLC

Vassiliki Papadimitrakopoulou, MD
Published Online:5:29 PM, Tue April 16, 2019

During the 2019 AACR Annual Meeting, Vassiliki Papadimitrakopoulou, MD, professor of medicine, Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center in Houston, discusses findings from the Noninvasive versus Invasive Lung Evaluation (NILE) study and what they mean for the clinical utility of liquid biopsies for the detection of biomarkers in non–small cell lung cancer (NSCLC).

NILE was a prospective multicenter noninferiority study that compared the utility of liquid biopsy using cell-free DNA (cfDNA) tumor profiling versus tumor tissue profiling. The study evaluated whether Guardant360—a 73-gene next-generation sequencing panel—can be used to detect all 7 guideline-recommended predictive biomarker mutations (EGFR, ALK, ROS1, BRAF, RET, MET, and ERBB2) and 1 prognostic biomarker mutation (KRAS) at the same rate as traditional tissue genotyping tests in patients with newly diagnosed advanced NSCLC.

The main finding from the trial is that liquid biopsies are equally effective in detecting guideline-recommended biomarkers in the tumor at a significantly faster rate (9 days vs 15 days), says Papadimitrakopoulou. In a comparison of biomarker detection, the positive predictive value for the cfDNA analysis was 100% and the sensitivity was 80%.

The findings from this study confirm clinical practitioners can use liquid biopsies as the first profiling test for patients at their practice. While it was already knows that liquid biopsies can provide biomarker detection, these prospective findings validated this information, she says. Physicians can now have confidence in using liquid biopsies to reliably detect alterations in the tumor, allowing them to guide treatment for their patients must faster than they would with tissue profiling.
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