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The Emerging Role of Liquid Biopsy in the Diagnosis and Management of CRC
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David Lieberman, MD, AGAF

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References

  1. Key statistics for colorectal cancer. American Cancer Society. Revised January 13, 2023. Accessed November 30, 2023. https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html 

  1. Mazouji O, Ouhajjou A, Incitti R, Mansour H. Updates on clinical use of liquid biopsy in colorectal cancer screening, diagnosis, follow-up, and treatment guidance. Front Cell Dev Biol. 2021;9:660924. doi:10.3389/fcell.2021.660924 

  1. Vacante M, Ciuni R, Basile F, Biondi A. The liquid biopsy in the management of colorectal cancer: an overview. Biomedicines. 2020;8(9):308. doi:10.3390/biomedicines8090308 

  1. American Cancer Society. Colorectal cancer facts & figures 2020-2022. Published 2022. Accessed November 30, 2023. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2020-2022.pdf 

  1. Johnson & Johnson. FDA clears Cellsearch™ circulating tumor cell test [news release]. Published February 27, 2008. Accessed November 30, 2023. https://johnsonandjohnson.gcs-web.com/news-releases/news-release-details/fda-clears-cellsearchtm-circulating-tumor-cell-test  

  1. US Food and Drug Administration. Summary of safety and effectiveness data, Epi proColon®. PMA number P130001. Published April 12, 2016. Accessed November 30, 2023. https://www.accessdata.fda.gov/cdrh_docs/pdf13/p130001b.pdf  

  1. FDA approves blood tests that can help guide cancer treatment. National Institutes of Health, National Cancer Institute. Published October 15, 2020. Accessed November 30, 2023. https://www.cancer.gov/news-events/cancer-currents-blog/2020/fda-guardant-360-foundation-one-cancer-liquid-biopsy  

  1. Foundation Medicine. US Food and Drug Administration (FDA) approves FoundationOne®LiquidCDx as a companion diagnostic for Pfizer’s BRAFTOVI® (encorafenib) in combination with cetuximab to identify patients with BRAF V600E alterations in metastatic colorectal cancer [press release]. Published June 10, 2023. Accessed November 30, 2023. https://www.foundationmedicine.com/press-releases/f9b285eb-db6d-4f61-856c-3f1edb803937 
     

Author and Disclosure Information

David Lieberman, MD, AGAF
Professor
Department of Medicine
Division of Gastroenterology
Oregon Health and Science University
Staff Physician
Department of Medicine
Portland VA Medical Center
Portland, Oregon

Disclosures:
Serve(d) as a consultant for: UDX; Geneoscopy
Received income in an amount equal to or greater than $250 from: Geneoscopy

Publications
GI and Hepatology News
Topics
GI Oncology
Author(s)
David Lieberman, MD, AGAF
Author(s)
David Lieberman, MD, AGAF
Author and Disclosure Information

David Lieberman, MD, AGAF
Professor
Department of Medicine
Division of Gastroenterology
Oregon Health and Science University
Staff Physician
Department of Medicine
Portland VA Medical Center
Portland, Oregon

Disclosures:
Serve(d) as a consultant for: UDX; Geneoscopy
Received income in an amount equal to or greater than $250 from: Geneoscopy

Author and Disclosure Information

David Lieberman, MD, AGAF
Professor
Department of Medicine
Division of Gastroenterology
Oregon Health and Science University
Staff Physician
Department of Medicine
Portland VA Medical Center
Portland, Oregon

Disclosures:
Serve(d) as a consultant for: UDX; Geneoscopy
Received income in an amount equal to or greater than $250 from: Geneoscopy

Click here to view more from Gastroenterology Data Trends 2024

Click here to view more from Gastroenterology Data Trends 2024

References

  1. Key statistics for colorectal cancer. American Cancer Society. Revised January 13, 2023. Accessed November 30, 2023. https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html 

  1. Mazouji O, Ouhajjou A, Incitti R, Mansour H. Updates on clinical use of liquid biopsy in colorectal cancer screening, diagnosis, follow-up, and treatment guidance. Front Cell Dev Biol. 2021;9:660924. doi:10.3389/fcell.2021.660924 

  1. Vacante M, Ciuni R, Basile F, Biondi A. The liquid biopsy in the management of colorectal cancer: an overview. Biomedicines. 2020;8(9):308. doi:10.3390/biomedicines8090308 

  1. American Cancer Society. Colorectal cancer facts & figures 2020-2022. Published 2022. Accessed November 30, 2023. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2020-2022.pdf 

  1. Johnson & Johnson. FDA clears Cellsearch™ circulating tumor cell test [news release]. Published February 27, 2008. Accessed November 30, 2023. https://johnsonandjohnson.gcs-web.com/news-releases/news-release-details/fda-clears-cellsearchtm-circulating-tumor-cell-test  

  1. US Food and Drug Administration. Summary of safety and effectiveness data, Epi proColon®. PMA number P130001. Published April 12, 2016. Accessed November 30, 2023. https://www.accessdata.fda.gov/cdrh_docs/pdf13/p130001b.pdf  

  1. FDA approves blood tests that can help guide cancer treatment. National Institutes of Health, National Cancer Institute. Published October 15, 2020. Accessed November 30, 2023. https://www.cancer.gov/news-events/cancer-currents-blog/2020/fda-guardant-360-foundation-one-cancer-liquid-biopsy  

  1. Foundation Medicine. US Food and Drug Administration (FDA) approves FoundationOne®LiquidCDx as a companion diagnostic for Pfizer’s BRAFTOVI® (encorafenib) in combination with cetuximab to identify patients with BRAF V600E alterations in metastatic colorectal cancer [press release]. Published June 10, 2023. Accessed November 30, 2023. https://www.foundationmedicine.com/press-releases/f9b285eb-db6d-4f61-856c-3f1edb803937 
     

References

  1. Key statistics for colorectal cancer. American Cancer Society. Revised January 13, 2023. Accessed November 30, 2023. https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html 

  1. Mazouji O, Ouhajjou A, Incitti R, Mansour H. Updates on clinical use of liquid biopsy in colorectal cancer screening, diagnosis, follow-up, and treatment guidance. Front Cell Dev Biol. 2021;9:660924. doi:10.3389/fcell.2021.660924 

  1. Vacante M, Ciuni R, Basile F, Biondi A. The liquid biopsy in the management of colorectal cancer: an overview. Biomedicines. 2020;8(9):308. doi:10.3390/biomedicines8090308 

  1. American Cancer Society. Colorectal cancer facts & figures 2020-2022. Published 2022. Accessed November 30, 2023. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2020-2022.pdf 

  1. Johnson & Johnson. FDA clears Cellsearch™ circulating tumor cell test [news release]. Published February 27, 2008. Accessed November 30, 2023. https://johnsonandjohnson.gcs-web.com/news-releases/news-release-details/fda-clears-cellsearchtm-circulating-tumor-cell-test  

  1. US Food and Drug Administration. Summary of safety and effectiveness data, Epi proColon®. PMA number P130001. Published April 12, 2016. Accessed November 30, 2023. https://www.accessdata.fda.gov/cdrh_docs/pdf13/p130001b.pdf  

  1. FDA approves blood tests that can help guide cancer treatment. National Institutes of Health, National Cancer Institute. Published October 15, 2020. Accessed November 30, 2023. https://www.cancer.gov/news-events/cancer-currents-blog/2020/fda-guardant-360-foundation-one-cancer-liquid-biopsy  

  1. Foundation Medicine. US Food and Drug Administration (FDA) approves FoundationOne®LiquidCDx as a companion diagnostic for Pfizer’s BRAFTOVI® (encorafenib) in combination with cetuximab to identify patients with BRAF V600E alterations in metastatic colorectal cancer [press release]. Published June 10, 2023. Accessed November 30, 2023. https://www.foundationmedicine.com/press-releases/f9b285eb-db6d-4f61-856c-3f1edb803937 
     

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The Emerging Role of Liquid Biopsy in the Diagnosis and Management of CRC
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Colorectal cancer (CRC) is the third most common cancer in the United States, and early detection and monitoring are crucial for improving patient outcomes.1 Liquid biopsy (LB) is a revolutionary approach that may offer a non-invasive way to diagnose and manage CRC. The history of LB for CRC reflects a progression from early attempts to detect biomarkers in blood to the current era of precise genetic analysis using circulating tumor deoxyribonucleic acid (ctDNA) and analyzed with next-generation sequencing. The technology has significantly improved over time, leading to the potential for integration into clinical practice and to provide more personalized and effective CRC management.2

LB offers several potential advantages for CRC screening compared to traditional non-invasive screening with a stool sample, or invasive screening with colonoscopy. A blood test that could identify high-risk individuals who need colonoscopy is exciting, because it is possible that adherence to screening would be improved with LB. However, there are many challenges. Reduction of CRC mortality or incidence will depend on the ability of the test to accurately detect individuals with early-stage cancer or precancerous advanced polyps. It is not clear if the biology of such lesions would result in an adequate signal in blood if the lesion were not invasive. Test performance also depends on completion of colonoscopy if individuals have an abnormal LB. Testing methods, cost consideration, and clinical validation of performance will need to be addressed.3 As the technology advances, the role of LB in CRC screening will likely evolve and expand.

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