The study includes a companion diagnostic being developed by Roche’s Foundation Medicine arm to profile tumor mutational burden via a blood sample. (Pixabay)
With new data in hand from an ongoing study exploring biomarkers for lung cancer, Genentech and Roche say that genomic blood tests could soon replace invasive tissue biopsies when assigning patients to targeted treatments.
Presented at the 2019 congress of the European Society for Medical Oncology, data from the Blood-First Assay Screening Trial, or BFAST, showed that a blood-based diagnostic was able to identify specific genetic mutations that help drive progression within the tumor, gathered from DNA fragments found floating in the bloodstream.
“One of the biggest recent changes in treatment of (non-small cell lung cancer, or NSCLC) has been our ability to identify targetable genetic mutations that drive progression of the disease, but it is a major challenge to get a suitable tumor sample for analysis,” study author Shirish Gadgeel, a professor at the University of Michigan Rogel Cancer Center, said in a statement.
The phase 2/3 trial screened over 2,000 patients with advanced, previously untreated NSCLC, using two next-generation sequencing blood tests. The tests—which include a companion diagnostic being developed by Roche’s Foundation Medicine arm, to examine the use of tumor mutational burden as a biomarker—check for several genetic mutations to help guide treatment choices.
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“We showed that liquid biopsy could be used to detect a complex type of driver mutation, called ALK, in patients with NSCLC,” Gadgeel added. “These then responded at least as well to targeted therapy as in previous studies using conventional biopsy techniques.”
About 5% of study participants had circulating tumor DNA showing ALK gene rearrangements, according to the companies, which is similar to proportions seen in traditional biopsy samples. Following assignment and treatment with the ALK inhibitor Alecensa (alectinib), more than 75% of patients showed no signs of disease progression after one year.
