Tumors: Who needs a liquid biopsy?

Regional networks of laboratories are needed to rapidly perform liquid biopsies. They are essential to determine the most appropriate treatment for patients, since these tests now allow, with a simple blood draw, to identify mutations targeted by new drugs. For example, in Tuscany, it is estimated that 400 women with metastatic breast cancer may need this test each year.

Identifying laboratories for liquid biopsy

A panel of representatives of clinicians, pharmacists, laboratory experts, and patients who participated in the "Liquid Biopsy in Er+/Her2- Metastatic Breast Cancer" project met in this region. In a document, they are now calling for the identification of regional reference laboratories for performing the test: some at university centers and others at local health authorities.

Tailor-made oncology

"Tuscan oncology is already highly structured and represents a center of excellence in the field of breast cancer," emphasizes Gianni Amunni , Scientific Coordinator of the Institute for the Study and Prevention of Oncology in Florence. "Multidisciplinary management of each individual case is essential: this approach promotes appropriate treatment and the development of increasingly personalized care pathways. Liquid biopsy, a diagnostic method of growing importance in the fight against cancer, falls within this process."

Who needs a liquid biopsy, and why?

In the most common metastatic breast cancer, hormone-responsive (ER+/HER2-), genomic testing performed via liquid biopsy is now used to identify the presence of ESR1 mutations, which are responsible for almost half of progressions after endocrine therapy: "Once these mutations are identified," Amunni continues, "it is possible to use the new drug elacestrant, a selective estrogen receptor degrader, consisting of orally administered tablets, capable of improving progression-free survival and postponing the need for other, more invasive treatments, such as chemotherapy."

Expertise and high standards

According to Agostino Ognibene , director of the Clinical Chemical Analysis Unit at the South-East Tuscany Local Health Authority, the number of patients eligible for this test will increase in the region: "For this reason," he says, "the Region needs to make a new organizational effort to ensure continued access to liquid biopsy testing. Only appropriate healthcare facilities with the right expertise should perform state-of-the-art tests, such as liquid biopsy."

But be careful when communicating with patients

"In addition to working on organizational aspects, which are fundamental, it is equally important for cancer centers to focus on communication with patients," concludes Loredana Pau , vice president and coordinator of the Europa Donna Italia association network. "Women living with metastatic breast cancer must be offered adequate information on available treatment innovations, also to ease the burden of a diagnosis that has a significant impact on their quality of life."