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Liquid Biopsies

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Adnerb View Drop Down
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    Posted: Apr 24 2014 at 11:20pm
Has anyone here ever tried having their blood biopsied?  It is supposed to tell you a lot more than a regular biopsy, i.e. recurrence possibility, types of mutations you have/will have, treatment options, etc.  Dr. Massimo Christofanilli from Jefferson hospital in PA apparently uses this non-invasive technique to treat and monitor his breast cancer patients.  It's a test that counts the circulating tumor cells (CTC) in a vial of blood.

I would like to know if anyone in this support group has ever tried it and how it worked for them.  I keep wanting to get to know my tumors better, but the last ct-guided needle biopsy did not even identify hormone receptors.

Thank you.

Brenda
'05 Stg1 TNBC Lump, SNB, A/C, 33 rads
'09 Stg2 ER-, PR+, Her2-, Bil.Mast., T/C, Arimidex.
'13 Stg4 Lung mets, ER+, PR-, Her2-, Carbo/Gemzar, Letrozole.
'14 Abraxane in July
'15 Abraxane in March
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Adnerb View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Adnerb Quote  Post ReplyReply Direct Link To This Post Posted: Apr 28 2014 at 2:01pm
I found a couple of ladies from bcmets.org who have tried liquid biopsy.  One did it at MDAnderson and the other one went to Cynvenio Biosystems.  For me the main downside is, if the biopsy finds a mutation for which there is no treatment, what would you do?

The research on CTC's (circulating tumor cells) has been extremely fast-paced in the past couple of years.  I think it's exciting.

Brenda
'05 Stg1 TNBC Lump, SNB, A/C, 33 rads
'09 Stg2 ER-, PR+, Her2-, Bil.Mast., T/C, Arimidex.
'13 Stg4 Lung mets, ER+, PR-, Her2-, Carbo/Gemzar, Letrozole.
'14 Abraxane in July
'15 Abraxane in March
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Adnerb View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Adnerb Quote  Post ReplyReply Direct Link To This Post Posted: Jun 12 2014 at 4:39pm
My doctor authorized my first liquid biopsy.  All I had to do was let the chemo nurse take one more vial of blood.  The hospital packaged it according to instructions and sent it to the company.  The company called me Monday (3 days ago) to say that they received my sample, have started the procedure,  and will share result with my doctor in 8 days.  I am patiently awaiting the time when my doctor shares the result with me.  I will post it here if anyone is interested.
'05 Stg1 TNBC Lump, SNB, A/C, 33 rads
'09 Stg2 ER-, PR+, Her2-, Bil.Mast., T/C, Arimidex.
'13 Stg4 Lung mets, ER+, PR-, Her2-, Carbo/Gemzar, Letrozole.
'14 Abraxane in July
'15 Abraxane in March
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jun 12 2014 at 5:22pm
Thanks Brenda!  Keep us posted.

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Adnerb Quote  Post ReplyReply Direct Link To This Post Posted: Jun 20 2014 at 7:11pm
This is intended only for those of you who showed interest.

I was shown a graph that illustrated the number of tumor cells in every milliliter of blood that was collected from me.

I am copying, word for word what I read under "result" on page 1 and page 2.

Page 1:

"Result Interpretation:  Result numbers below the reference line indicate that sample tested revealed the quantity of nucleated cytokeratin positive and CD45 negative cells is within the range found in general population.  Purity numbers above 10% represent good candidate samples for further analysis, if such analysis is selected. 1.9 target cells per ml were identified in the analysis. Results below 9 cells/ml show greater variation upon repeat analysis and hence are reported as <9 cells/ml."

Page 2:

"Results:  No Mutation(s) detected."

So I am being told once again that I have no disease or not enough disease to evaluate so I can use more targeted treatment approaches.

This happened to me before.  I was 4 weeks into treatment when I went to the imaging place to get a ct-guided needle biopsy of the numerous tumors in the lining of my left lung.  Alas, the tumors were all gone and there was nothing to biopsy.

I know I should be glad that the blood biopsy did not say I had 200 mutations and no known available treatment.  But when will I get to know this beast better?

My MO said if (God forbid) I progress again, we shall do another liquid biopsy even before treatment starts.

Thank you for your interest.

Hugs,

Brenda
'05 Stg1 TNBC Lump, SNB, A/C, 33 rads
'09 Stg2 ER-, PR+, Her2-, Bil.Mast., T/C, Arimidex.
'13 Stg4 Lung mets, ER+, PR-, Her2-, Carbo/Gemzar, Letrozole.
'14 Abraxane in July
'15 Abraxane in March
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Post Options Post Options   Thanks (0) Thanks(0)   Quote btstark2003 Quote  Post ReplyReply Direct Link To This Post Posted: Jun 20 2014 at 11:02pm
Brenda,

Good news for you!  Thanks for sharing, this is really cutting edge technology.  I haven't heard of anyone else using it so will check into it.  

Beth
2008 Stg1 TNBC, LX, FEC+T, rads
2010 2.5cm tumor BRCA-, BMX,CMF
2011 LN mets, Gem/Carbo, surgery, rads
2012 lung mets, PI3Ki/taxo
2013 anti-PD-1
2014/15 Xeloda, IMMU-132, eribulin
Aug 2015 Keytruda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Apr 21 2016 at 8:11am
USC patient data demonstrates potential of Parsortix for metastatic breast cancer liquid biopsy clinical application

University of Southern California (USC) Norris Comprehensive Cancer Center's ongoing work with ANGLE's Parsortix system have demonstrated the potential for the use of Parsortix as a liquid biopsy for metastatic breast cancer.

USC head to head patient data was presented at AACR 2016 (the American Association for Cancer Research Annual Meeting 2016), which demonstrates a statistically significant correlation in metastatic breast cancer between analysis of CTCs (circulating tumor cells) harvested from a simple blood test using Parsortix with similar analysis of tissue obtained from invasive biopsy of a secondary cancer site. The Directors believe that the data demonstrates the potential for the Parsortix liquid biopsy (simple blood test) to replace the invasive biopsy.

Metastasis is responsible for the vast majority of breast cancer related deaths. Initial treatment recommendations for breast cancer are based on primary tumor biology from the initial solid biopsy at patient presentation. However, the recently updated ASCO (American Society of Clinical Oncology) guidelines call for biopsy of a metastatic site to guide the decision making for treatment as it is known that cancers change their status as disease progresses. Access to the secondary cancer site to obtain this tissue biopsy is challenging and requires the patient to undergo an invasive procedure, which causes trauma and delays treatment until they have recovered from the procedure. Furthermore the surgical intervention takes time to arrange, is expensive and diverts resources from care for the patient.

A liquid biopsy to obtain cancer cells for analysis from a simple blood test has major advantages, including:

  • avoiding the patient suffering invasive procedures;
  • reducing the time to treatment decision;
  • providing information on all cancer sites at the same time rather than just a single site;
  • enabling serial assessment of tumor biology over time (repeat tissue biopsies are not generally acceptable to patients); and
  • reducing costs.

In the USC study, the tissue from the invasive biopsy and the CTCs from the Parsortix liquid biopsy harvest were both subjected to Illumina's whole-transcriptome analysis using total RNA sequencing (RNA-Seq). RNA-Seq can accurately measure gene and transcript abundance, and identify known and novel features of the transcriptome. RNA-Seq analysis has been completed on three sample types covering metastatic tissue biopsy, Parsortix harvested CTCs and, as a control, peripheral blood for each of eight patients. This strategy enables measurement of thousands of genes at once in order to generate a comprehensive picture of cellular function.

For every one of these patients, CTCs were successfully harvested and RNA-Seq analysis successfully completed. This analysis demonstrated a statistically significant correlation between the expression signature of 192 genes in the Parsortix harvested CTCs with similar analysis of tissue obtained from an invasive biopsy of a secondary cancer site.

The metastatic biopsy material was sourced from a wide range of metastatic sites including skin, pleural effusion (fluid around the lung), pericardial effusion (fluid around the heart), breast, cerebrospinal fluid (fluid found in the brain and spine) and bone tissue. For all of these different metastatic sites, the Parsortix CTCs provided similar gene expression compared to the metastatic biopsy, allowing for the potential examination of known and novel genes related to breast cancer.

These results suggest that by using Parsortix the same clinically relevant information may be obtained from a patient blood test as from an invasive metastatic biopsy regardless of its location in the patient.

Furthermore a comparison of overall gene expression using Parsortix harvested CTCs and the metastatic biopsy was undertaken for different druggable pathways. 66 potentially clinically actionable genes (i.e. gene targets against which a drug is already available either FDA approved or in clinical trials) were investigated and again there was no statistically significant difference in gene expression between CTCs and invasive tissue biopsy, covering 9 unique pathways. This suggests that the Parsortix system has the potential to be a useful tool for identifying drug targets in metastatic breast cancer and might be utilised to assess the effectiveness of drugs under development in clinical trials.

Replacement of the metastatic biopsy for breast cancer with a Parsortix blood test would be non-invasive, cheaper and faster, and could be repeated more frequently, thereby providing "real-time" information for therapy selection reflecting disease progression.

To read the entire article:

http://www.medicalnewstoday.com/releases/309339.php


DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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