In the most advanced strategies against cancer, such as immunotherapy and targeted therapies, molecular diagnosis is essential. Why? Because, according to the experts gathered at the VI Liquid Biopsy Symposium, it is thus possible to predict whether a treatment may or may not work on a given patient.
No cancer patient is the same as another, and the differences depend on the molecular alterations that the tumor cells present. Hence, any technology that helps determine what those distinctive marks are is good for advancing treatments.
Early diagnosis
One of the main tools to find out is the liquid biopsy, a non-invasive cancer diagnosis technique for which it is enough to take one or more biological samples, mainly blood. In order to make an early diagnosis, the laboratory will look for tumor cells that confirm or rule out cancer. And once the patient is in treatment, the liquid biopsy can also help detect minimal residual disease, that is, the small number of cancer cells that remain in the body after therapy. In summary, this technique reveals both the situation of the tumor in real time and its genetic and molecular alterations.
According to Rafael López, head of the Oncology Service of the Santiago University Clinical Hospital (La Coruña), “it will be, and is beginning to be, the main tool for developing precision oncology”. It works with two ingredients: drugs and biomarkers, as the biological molecules that indicate the presence of the disease are known . “60% of the drugs that are registered are already associated with a biomarker,” says López. The president of the Foundation for Excellence and Quality in Oncology (ECO), Vicente Guillem, considers that the identification of biomarkers is one of the most important advances in the fight against cancer.
Access to biomarkers
But is this technology being used in Spain? The answer is no, and the reason is clear: there is no national strategy that allows it to be used fairly in the hospital network . This is what the Spanish Society of Medical Oncology (SEOM) has been warning for a long time, which, as explained by its president, Álvaro Rodríguez-Lescure, a few months ago sent the complete list of biomarkers necessary in each type of tumor to the Ministry of Health so that integrate them into the Basic Portfolio of Services of the National Health System. “It is necessary to have one or more strategies that incorporate them”, López remarks. Because just as it is important to guarantee patient access to new therapies, it is important to do so with biomarkers , says Rodríguez-Lescure. “Today, it is impossible to manage cancer patients without having these molecular determinations,” he explains. Guillem.
The number of targeted therapies – those that, unlike conventional chemotherapy, selectively target certain tumor genes or proteins – continues to grow: there are already more than 200 approved by the US Food and Drug Administration (FDA). In fact, in 2019, more than 50% of all therapies were of this type and required a biomarker.
