Liquid biopsies can identify any remaining illness after cervical chemoradiation: Study

VIRGINIA: According to a recent study, two liquid biopsy methods that identify people at high risk of developing cervical cancer again after chemoradiation by looking for the presence of the human papillomavirus (HPV) in their blood did a good job of doing so.

Findings are presented at the American Society for Radiation Oncology's (ASTRO) annual meeting.

A digital polymerase chain reaction (dPCR) test and a sequencing test for HPV, the primary cause of cervical cancer, were compared in the study, and it was discovered that both were equally effective at detecting residual disease in the blood of cervical cancer patients who had just finished radiation and chemotherapy.

Early diagnosis enables earlier treatment of the disease's lingering symptoms, potentially improving survival rates.

"These non-invasive tests can detect residual disease following chemoradiation treatment earlier than imaging or a clinical exam," said lead study author Kathy Han, MD, a radiation oncologist at the Princess Margaret Cancer Center at the University of Toronto.

"We can detect very minimal disease, before it grows bigger, which potentially will enable us to intervene earlier and improve outcomes for people with cervical cancer."

Roughly 11,500 new cases of cervical cancer are diagnosed annually in the U.S., and an estimated 4,000 Americans die from the disease each year.

Approximately 30-40% of patients with cervical cancer develop tumor recurrence following chemoradiation, and currently, residual disease is often detected too late to improve survival rates.

Tissue biopsy has long been considered the gold standard for identifying tumors, but it requires an invasive procedure to sample enough tumor tissue to be visualized on imaging, and it provides a snapshot only of a specific tumor region.

Liquid biopsies can detect microscopic components of tumors in bodily fluids such as blood or urine, providing a less invasive option to assess malignancy. Blood tests are the most widely used type of liquid biopsy and can identify circulating tumor DNA (ctDNA), circulating RNA and other markers that signal the presence of cancer, including HPV.

Because these tests can detect fragments of the HPV virus that remain in the blood following chemoradiation but before tumors recur, "liquid biopsies provide insight before tissue biopsy becomes possible," said Dr Han.

"If we can predict who might be at higher risk of recurrence, it may be a signal to clinicians to make sure these patients are followed more closely."