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    Towards Routine Implementation of Liquid Biopsies in Cancer Management: It Is Always Too Early, until Suddenly It Is Too Late

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    Author
    IJzerman, MJ; de Boer, J; Azad, A; Degeling, K; Geoghegan, J; Hewitt, C; Hollande, F; Lee, B; To, YH; Tothill, RW; ...
    Date
    2021-01-01
    Source Title
    Diagnostics
    Publisher
    MDPI
    University of Melbourne Author/s
    Degeling, Koen; Tothill, Richard; Dawson, Sarah-Jane; Tie, Jeanne; Lee, Belinda; IJzerman, Maarten; Azad, Arun
    Affiliation
    Melbourne School of Population and Global Health
    Clinical Pathology
    Sir Peter MacCallum Department of Oncology
    Medical Biology (W.E.H.I.)
    Metadata
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    Document Type
    Journal Article
    Citations
    IJzerman, M. J., de Boer, J., Azad, A., Degeling, K., Geoghegan, J., Hewitt, C., Hollande, F., Lee, B., To, Y. H., Tothill, R. W., Wright, G., Tie, J. & Dawson, S. -J. (2021). Towards Routine Implementation of Liquid Biopsies in Cancer Management: It Is Always Too Early, until Suddenly It Is Too Late. DIAGNOSTICS, 11 (1), https://doi.org/10.3390/diagnostics11010103.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/259968
    DOI
    10.3390/diagnostics11010103
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826562
    Abstract
    Blood-based liquid biopsies are considered a new and promising diagnostic and monitoring tool for cancer. As liquid biopsies only require a blood draw, they are non-invasive, potentially more rapid and assumed to be a less costly alternative to genomic analysis of tissue biopsies. A multi-disciplinary workshop (n = 98 registrations) was organized to discuss routine implementation of liquid biopsies in cancer management. Real-time polls were used to engage with experts' about the current evidence of clinical utility and the barriers to implementation of liquid biopsies. Clinical, laboratory and health economics presentations were given to illustrate the opportunities and current levels of evidence, followed by three moderated break-out sessions to discuss applications. The workshop concluded that tumor-informed assays using next-generation sequencing (NGS) or PCR-based genotyping assays will most likely provide better clinical utility than tumor-agnostic assays, yet at a higher cost. For routine application, it will be essential to determine clinical utility, to define the minimum quality standards and performance of testing platforms and to ensure their use is integrated into current clinical workflows including how they complement tissue biopsies and imaging. Early health economic models may help identifying the most viable application of liquid biopsies. Alternative funding models for the translation of complex molecular diagnostics, such as liquid biopsies, may also be explored if clinical utility has been demonstrated and when their use is recommended in multi-disciplinary consensus guidelines.

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