Dr. Ciombor Discusses Role of Liquid Biopsies in CRC

Kristen Ciombor, MD, MSCI, assistant professor of medicine, Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, discusses the role of liquid biopsies in colorectal cancer (CRC).

Over the last decade or so, the gold standard has been tissue-based molecular profiling, Ciombor says. Technology has since advanced, enabling patients to undergo liquid biopsies as a way of identifying alterations and monitoring their tumor for patterns of resistance. The field is moving very quickly in this space. At this pace, patients may not have to undergo invasive tissue biopsies. Ideally, the goal of liquid biopsies is to provide a more precision-based approach to patients in detecting mechanisms of resistance to therapy.

In CRC, a number of biomarkers have emerged that can be paired with effective targeted therapy. For example, patients who express microsatellite instability—high or mismatch repair deficiency in their tumors can benefit from checkpoint inhibitors. There are also FDA-approved therapies for patients with NTRK fusions and promising targeted agents for patients who harbor BRAF V600E mutations, HER2 overexpression, and RAS mutations. Recent data have shown that liquid biopsies can detect these molecular characteristics with high sensitivity.