Recommendations for the Equitable and Widespread Implementation of Liquid Biopsy for Cancer Care

Overview

Journal JCO Precis Oncol

Specialty Oncology

Date 2024 Jan 2

PMID 38166232

Authors

Phillip G Febbo

Mina Allo

Emma B Alme

Gebra Cuyun Carter

Robert Dumanois

Alessia Essig

Estevan Kiernan

Caitlin B Kubler

Nikki Martin

Medeea C Popescu

Lauren C Leiman

Affiliations

Soon will be listed here.

Abstract

Liquid biopsies-tests that detect circulating tumor cellular components in the bloodstream-have the potential to transform cancer by reducing health inequities in screening, diagnostics, and monitoring. Today, liquid biopsies are being used to guide treatment choices for patients and monitor for cancer recurrence, and promising work in multi-cancer early detection is ongoing. However, without awareness of the barriers to adoption of this new technology and a willingness to build mitigation efforts into the implementation of widespread liquid biopsy testing, the communities that could most benefit may be the last to access and use them. In this work, we review the challenges likely to affect the accessibility of liquid biopsies in both the general population and underserved populations, and recommend specific actions to facilitate equitable access for all patients.

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References

Sharpless N . COVID-19 and cancer. Science. 2020; 368(6497):1290. DOI: 10.1126/science.abd3377. View

Thompson J, Aggarwal C, Wong J, Nimgaonkar V, Hwang W, Andronov M . Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC-Results From a Prospective Pilot Study. JTO Clin Res Rep. 2022; 3(4):100301. PMC: 8980884. DOI: 10.1016/j.jtocrr.2022.100301. View

Bayle A, Bonastre J, Chaltiel D, Latino N, Rouleau E, Peters S . ESMO study on the availability and accessibility of biomolecular technologies in oncology in Europe. Ann Oncol. 2023; 34(10):934-945. DOI: 10.1016/j.annonc.2023.06.011. View

Merker J, Oxnard G, Compton C, Diehn M, Hurley P, Lazar A . Circulating Tumor DNA Analysis in Patients With Cancer: American Society of Clinical Oncology and College of American Pathologists Joint Review. J Clin Oncol. 2018; 36(16):1631-1641. DOI: 10.1200/JCO.2017.76.8671. View

Sauer A, Siegel R, Jemal A, Fedewa S . Current Prevalence of Major Cancer Risk Factors and Screening Test Use in the United States: Disparities by Education and Race/Ethnicity. Cancer Epidemiol Biomarkers Prev. 2019; 28(4):629-642. DOI: 10.1158/1055-9965.EPI-18-1169. View

Cykert S, Eng E, Manning M, Robertson L, Heron D, Jones N . A Multi-faceted Intervention Aimed at Black-White Disparities in the Treatment of Early Stage Cancers: The ACCURE Pragmatic Quality Improvement trial. J Natl Med Assoc. 2019; 112(5):468-477. DOI: 10.1016/j.jnma.2019.03.001. View

Smith A, Woerner J, Perera R, Haeny A, Cox J . An Investigation of Associations Between Race, Ethnicity, and Past Experiences of Discrimination with Medical Mistrust and COVID-19 Protective Strategies. J Racial Ethn Health Disparities. 2021; 9(4):1430-1442. PMC: 8195452. DOI: 10.1007/s40615-021-01080-x. View

IJzerman M, de Boer J, Azad A, Degeling K, Geoghegan J, Hewitt C . Towards Routine Implementation of Liquid Biopsies in Cancer Management: It Is Always Too Early, until Suddenly It Is Too Late. Diagnostics (Basel). 2021; 11(1). PMC: 7826562. DOI: 10.3390/diagnostics11010103. View

Garfield S, Polisena J, Spinner D, Postulka A, Lu C, Tiwana S . Health Technology Assessment for Molecular Diagnostics: Practices, Challenges, and Recommendations from the Medical Devices and Diagnostics Special Interest Group. Value Health. 2016; 19(5):577-87. DOI: 10.1016/j.jval.2016.02.012. View

10.

Martin N, Tepper J, Giri V, Stinchcombe T, Cheng H, Javle M . Adopting Consensus Terms for Testing in Precision Medicine. JCO Precis Oncol. 2021; 5. PMC: 8509918. DOI: 10.1200/PO.21.00027. View

11.

Griffith D . Precision Medicine Approaches to Health Disparities Research. Ethn Dis. 2020; 30(Suppl 1):129-134. PMC: 7138443. DOI: 10.18865/ed.30.S1.129. View

12.

Rivenbark J, Ichou M . Discrimination in healthcare as a barrier to care: experiences of socially disadvantaged populations in France from a nationally representative survey. BMC Public Health. 2020; 20(1):31. PMC: 6953466. DOI: 10.1186/s12889-019-8124-z. View

13.

Douglas M, Ragavan M, Chen C, Kumar A, Gray S, Blakely C . Private Payer and Medicare Coverage Policies for Use of Circulating Tumor DNA Tests in Cancer Diagnostics and Treatment. J Natl Compr Canc Netw. 2023; 21(6):609-616.e4. PMC: 10846388. DOI: 10.6004/jnccn.2023.7011. View

14.

Nong P, Raj M, Creary M, Kardia S, Platt J . Patient-Reported Experiences of Discrimination in the US Health Care System. JAMA Netw Open. 2020; 3(12):e2029650. PMC: 7739133. DOI: 10.1001/jamanetworkopen.2020.29650. View

15.

Reddy S, Broder M, Chang E, Paydar C, Chung K, Kansal A . Cost of cancer management by stage at diagnosis among Medicare beneficiaries. Curr Med Res Opin. 2022; 38(8):1285-1294. DOI: 10.1080/03007995.2022.2047536. View

16.

Williams P, Zaidi S, Sengupta R . AACR Cancer Disparities Progress Report 2022. Cancer Epidemiol Biomarkers Prev. 2022; 31(7):1249-1250. DOI: 10.1158/1055-9965.EPI-22-0542. View

17.

Siegel R, Miller K, Fuchs H, Jemal A . Cancer statistics, 2022. CA Cancer J Clin. 2022; 72(1):7-33. DOI: 10.3322/caac.21708. View

18.

Vidula N, Niemierko A, Malvarosa G, Yuen M, Lennerz J, Iafrate A . Tumor Tissue- versus Plasma-based Genotyping for Selection of Matched Therapy and Impact on Clinical Outcomes in Patients with Metastatic Breast Cancer. Clin Cancer Res. 2021; 27(12):3404-3413. DOI: 10.1158/1078-0432.CCR-20-3444. View

19.

Napolitano S, Caputo V, Ventriglia A, Martini G, Della Corte C, De Falco V . Liquid Biopsy at Home: Delivering Precision Medicine for Patients with Cancer During the COVID-19 Pandemic. Oncologist. 2022; 27(8):e633-e641. PMC: 9355826. DOI: 10.1093/oncolo/oyac071. View

20.

Kasi P, Fehringer G, Taniguchi H, Starling N, Nakamura Y, Kotani D . Impact of Circulating Tumor DNA-Based Detection of Molecular Residual Disease on the Conduct and Design of Clinical Trials for Solid Tumors. JCO Precis Oncol. 2022; 6:e2100181. PMC: 8926064. DOI: 10.1200/PO.21.00181. View