Podcasts about Liquid biopsy

Cornelia Kropf-Sanchen und Harald Müller-Huesmann diskutieren Studien zum kleinzelligen und nicht-kleinzelligen Lungenkarzinom – darunter Immun-Chemo-Kombinationen, molekulare Rebiopsien bei Resistenzen und ctDNA als Marker für Therapieentscheidungen. Und auch die Nachwuchsförderung wird beleuchtet.

Drs Park and Malla began by talking through the clinical utility of ctDNA in patients with stage II and III colon cancer. Dr Malla referenced the DYNAMIC (ACTRN12615000381583) and observational BESPOKE CRC (NCT04264702) trials, noting that ctDNA serves as a prognostic biomarker for recurrence and is increasingly used to guide post-surgical surveillance.

In this episode of Conversations in Lung Cancer Research, A/Prof Mel Moore speaks with Prof Wendy Cooper, a leading pathologist in cancer research. They discuss Wendy's journey into pathology, the evolution of lung cancer diagnostics, the impact of AI and liquid biopsies, and the importance of international collaboration in research. Wendy shares insights on the challenges of equitable access to cancer diagnostics and the pressures faced by pathologists in multidisciplinary meetings. The conversation concludes with advice for junior clinicians on career development and involvement in professional organisations.(00:00) Introduction and Acknowledgements(00:36) Introducing Prof Wendy Cooper(01:32) Wendy's Path to Pathology(04:42) The Evolution of Lung Cancer Pathology(08:18) The Role of AI in Pathology(10:30) Translational Research and International Collaboration(14:09) Molecular Testing Guidelines in Australia(18:05) Challenges and Future Directions in Pathology(26:52) The Impact of Lung Cancer Screening Programs(29:08) Final Thoughts and Advice 

Imagine a future where you go in for your annual check-up and get a blood test to screen for cancer, in the same way you currently get screened for high cholesterol or diabetes. Some hope that liquid biopsy technology could eventually make this possible — but it has a long way to go before it gets to that point. Laborastories host Dr. Anthony Killeen sits down with Dr. Christina Lockwood for a realistic outlook on this exciting technology and an overview of the challenges that must be overcome before it's put into routine use. With special guest: Dr. Christina Lockwood Hosted by: Dr. Anthony Killeen

In dieser Folge von O-Ton Onkologie spricht Antje Blum, Chefredakteurin des Journal Onkologie, mit Prof. Dr. Christian Kratz von der Medizinischen Hochschule Hannover über genetische Krebsdispositionssyndrome im Kindesalter. Im Mittelpunkt stehen frühe Diagnosemöglichkeiten, Herausforderungen in der Versorgung und neue Forschungsansätze – inklusive Früherkennung, psychosozialer Begleitung und klinischer Studien zu Präventionsstrategien wie Metformin. Rund 2.000 Kinder erkranken in Deutschland jährlich an Krebs – bei etwa 10 % liegt ein genetisches Krebsdispositionssyndrom (KPS) zugrunde. Für viele KPS-Formen fehlen derzeit spezialisierte Versorgungsstrukturen. An der MHH wurde daher eine eigene Ambulanz für betroffene Kinder eingerichtet, die neben genetischer Diagnostik auch strukturierte Früherkennungsprogramme ermöglicht. Insbesondere das Li-Fraumeni-Syndrom erfordert ein umfassendes Monitoring – inklusive jährlichem Ganzkörper-MRT. Doch auch psychosoziale Begleitung wird zunehmend als essenziell erkannt, ist aber noch nicht ausreichend finanziert. Im Rahmen eines bundesweiten Registers sammeln Prof. Kratz und Kolleg:innen umfassende Daten zu genetischen Prädispositionen. Ziel ist eine individualisierte Risikobewertung und Präventionsstrategie. Eine neue klinische Studie untersucht derzeit, ob Metformin das Krebsrisiko bei Betroffenen senken kann. Parallel wird an der Entwicklung von Liquid Biopsy und sogar Impfstrategien geforscht. Zur Folgen-Übersicht: https://bit.ly/3NJPbAC Weiterführende Informationen: (1) Register: http://www.krebs-praedisposition.de/kps-forschung/kps-register/ https://www.krebs-praedisposition.de/kps-forschung/fanconi-anaemie-register/ (2) Selbsthilfe: Li-Fraumeni Syndrome Association Deutschland: https://lfsa-deutschland.de/ (3) Kratz, C.P. Re-envisioning genetic predisposition to childhood and adolescent cancers. Nat Rev Cancer 25, 109–128 (2025). https://doi.org/10.1038/s41568-024-00775-7 (4) O-Ton Onkologie (Staffel 3) Folge "Lynch-Syndrom – häufigste Ursache für den erblich bedingten Dickdarmkrebs": https://soundcloud.com/o-ton-onkologie/lynch-syndrom-haeufigste-ursache-fur-den-erblich-bedingten-dickdarmkrebs Podcast-Tipps des Gastes: New York Times the daily: https://podcasts.apple.com/de/podcast/the-daily/id1200361736 New York Times the headlines: https://podcasts.apple.com/de/podcast/the-headlines/id1758855019 Diese Podcast-Staffel wird ermöglicht durch Fortimel - medizinische Trinknahrung. Wir danken unserem Partner für die Unterstützung der Produktion dieses Audio-Formats. Unsere Sponsoring-Partner haben keinen Einfluss auf die Inhalte. Fortimel Trinknahrungen sind Lebensmittel für besondere medizinische Zwecke (bilanzierte Diät). Zum Diätmanagement bei krankheitsbedingter Mangelernährung. Nur unter ärztlicher Aufsicht verwenden.

In this episode of “Answers From the Lab,” William Morice II, M.D., Ph.D., CEO and president of Mayo Clinic Laboratories, invited Min-Han Tan, M.B.B.S., FRCP, Ph.D., founding CEO and medical director of Lucence, to discuss liquid biopsy cancer testing. Mayo Clinic Laboratories and Lucence recently announced a collaboration to expand access to this cutting-edge cancer test that is designed to detect clinically relevant biomarkers in ctDNA and ctRNA.During their conversation, Dr. Morice and Dr. Tan explore:Inspiration for developing the liquid biopsy.Features that differentiate LiquidHALLMARK® from existing cancer tests.Patients who will benefit from the test and how an oncologist might use the results.The future potential of liquid biopsy advancements.

In this episode of Conversations in Lung Cancer Research, Dr. Malinda Itchins, Dr. Annie Wong, and A/Prof Stephen Kao discuss the concept of liquid biopsy, its advantages and limitations, and its clinical applications in lung cancer treatment. They explore how liquid biopsy can provide faster diagnosis and treatment options, especially for patients who cannot undergo traditional tissue biopsies. However, they also address the challenges of sensitivity and the need for further research to integrate liquid biopsy into routine clinical practice.This episode is sponsored by: AstraZeneca  Daiichi Sankyo Australia  SOPHiA Genetics  Thermo Fisher Scientific(00:00) Introduction and Acknowledgements(01:16) Meet the Experts(02:10) Understanding Liquid Biopsy(03:01) Advantages of Liquid Biopsy(06:21) Limitations of Liquid Biopsy(09:15) Clinical Scenarios for Liquid Biopsy(13:15) Barriers and Future Directions(19:39) Conclusion and Thank You

In this weeks VJOncology podcast, three oncology experts delve into the transformative potential of liquid biopsy in breast cancer treatment.... The post Liquid biopsy in breast cancer appeared first on VJOncology.

Physician Ash Alizadeh has seen the future of disease diagnosis and monitoring. It is coursing through every patient's veins. Traditionally, biopsies have required invasively gathering tissue – from a lung, a liver, or a fetus. Now it's possible to look for disease without surgery. The DNA is sitting there in the bloodstream, Alizadeh tells host Russ Altman, as they preview the age of liquid biopsies on this episode of Stanford Engineering's The Future of Everything podcast.Have a question for Russ? Send it our way in writing or via voice memo, and it might be featured on an upcoming episode. Please introduce yourself, let us know where you're listening from, and share your quest. You can send questions to thefutureofeverything@stanford.edu.Episode Reference Links:Stanford Profile: Ash A. Alizadeh, MD/PhDConnect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads / Bluesky / MastodonConnect with School of Engineering >>> Twitter/X / Instagram / LinkedIn / FacebookChapters:(00:00:00) IntroductionRuss Altman introduces guest Ash Alizadeh, a faculty member at Stanford University in Oncology and Medicine.(00:03:39) What is a Liquid Biopsy?Accessing tissues non-invasively using bodily fluids.(00:04:31) Detecting Cancer with Liquid BiopsiesHow localized cancers can be detected through blood samples.(00:06:32) The Science Behind Cancer DNA DetectionThe differences between normal and cancer DNA(00:09:51) How Liquid Biopsy Technology WorksThe technologies behind detecting cancer-related DNA differences.(00:12:36) Advances in Liquid BiopsyNew detection approaches using non-mutant molecules and RNA.(00:14:10) RNA as a Real-Time Tumor MarkerHow RNA reveals active tumor processes and drug resistance.(00:15:55) Tracking Cancer ReccurenceUsing tumor-informed panels to monitor cancer recurrence.(00:16:28)  Adapting to Tumor EvolutionWhy core mutations remain detectable despite cancer changes.(00:17:57) Stability of DNA, RNA, and MethylationComparing durability and reliability of different biomarkers.(00:20:49) Listener Question: Early Cancer DetectionDaniel Kim asks about pre-cancer detection and its potential impact.(00:24:44) Liquid Biopsy in ImmunotherapyUsing liquid biopsy to track and improve immune-based treatments.(00:27:35) Monitoring CAR T-Cell TherapyHow liquid biopsy helps assess immune cell expansion.(00:32:02) EPIC-Seq: Inferring RNA from DNAUsing DNA fragmentation to predict gene expression in tumors.(00:34:49) Targeting Tumor Support SystemsTreatment strategies disrupting the tumor microenvironment.(00:35:52) Conclusion Connect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads / Bluesky / MastodonConnect with School of Engineering >>>Twitter/X / Instagram / LinkedIn / Facebook

Imagine detecting cancer with just a single drop of blood. In this episode of the Beautifully Broken Podcast, host Freddie Kimmel engages in a compelling conversation with Dr. Joshua Routh, MD, a distinguished expert in pathology and molecular oncology. Dr. Routh serves as the Laboratory Director for high-complexity clinical laboratories and holds the position of Associate Professor of Pathology at Midwestern University. He is also the Medical Director for Precision Epigenomics Inc., where he focuses on multi-cancer early detection tests.Together, they examine the science behind EPISEEK, discussing how it analyzes epigenetic markers in the blood to identify potential cancer signals. The conversation covers the importance of methylation in gene expression, the emotional implications of cancer testing, and who should consider getting tested. Dr. Routh emphasizes the need for patient autonomy and informed decision-making in the context of cancer screening. They also explore the advancements in multi-cancer early detection tests, focusing on the technology behind EPISEEK, its cost, and the current lack of insurance coverage. The discussion touches on the implications of abnormal test results, the importance of patient-doctor collaboration, and the need for a holistic approach to health that includes lifestyle factors. Additionally, they discuss the strengths and limitations of current cancer detection technologies and the importance of comprehensive health monitoring.Highlights1:32 Introduction: Personal Reflections on the Importance of Early Cancer Detection3:05 Understanding EpiSeek: A Breakthrough in Liquid Biopsy Technology for Cancer Detection5:40 The Science of EpiSeek: How It Works to Detect Cancer Early8:14 The Role of Methylation in Gene Expression and Its Link to Cancer Growth10:42 Gene Expression and Epigenetics: Why They Matter in Cancer Screening13:20 Interpreting Test Results: What to Do After Receiving an Abnormal Finding16:35 Who Should Get Tested? Assessing Risk Factors, Family History, and Lifestyle19:48 The Emotional Impact of Cancer Screening and the Decision Not to Test22:14 Comparing EpiSeq to Other Multi-Cancer Early Detection Tests25:52 Insurance Coverage for Multi-Cancer Tests: Current Challenges and Future Prospects29:30 Next Steps After an Abnormal Test Result: Further Screening and Actions33:40 The War on Cancer: How Lifestyle Choices Influence Cancer Risk36:15 - Evaluating the Strengths and Limitations of Current Cancer Detection Technologies40:28 - The Importance of Comprehensive Health Monitoring Beyond Single TestsUPGRADE YOUR WELLNESSEpiSeq Test: https://www.precision-epigenomics.com/episeqExclusive $50 Discount Offer (Valid Until August 1, 2025): https://www.precision-epigenomics.com/offerSilver Biotics Muscle Cream: https://www.silverbiotics.com (Use Code: BEAUTIFULLYBROKEN for Discount)Saga Bands: https://ca.saga.fitness/?ref=titvyccmCode: beautifullybrokenStemRegen: https://www.stemregen.co/products/stemregen?_ef_transaction_id=&oid=1&affid=52Code: beautifullybrokenLightPathLED https://lightpathled.pxf.io/c/3438432/2059835/25794Code: beautifullybroken CONNECT WITH FREDDIE Check out my website and store: (http://www.beautifullybroken.world) Instagram: (https://www.instagram.com/beautifullybroken.world/) YouTube: (https://www.youtube.com/@BeautifullyBrokenWorld)

Heute spreche ich mit Dr. Jan Hennigs vom neuen Years Medical Center in Berlin. Die Klinik bietet als erste ihrer Art in Deutschland eine Kombination aus klassischer evidenzbasierter Diagnostik und innovativer Longevity-Medizin. Viele fragen sich: Wo stehe ich im Alterungsprozess? Welche gesundheitlichen Stärken habe ich, und wo lauern Risiken? Genau diesen Fragen widmet sich Dr. Hennigs, Mitbegründer und medizinisch-wissenschaftlicher Leiter von Years, studierter Mediziner und Molekularbiologe, 15 Jahre lang Oberarzt und Forschungsgruppenleiter am Uniklinikum Hamburg-Oppendorf sowie vier Jahre Dozent an der Stanford University.   In dieser Folge sprechen wir u.a. über folgende Themen: Welche wissenschaftlichen Kriterien und Studien fließen in die Entwicklung der Diagnostikprogramme von Years ein? Welche diagnostischen Verfahren umfasst der umfassende Blutscreening-Test im CORE-Paket und warum sind bestimmte Marker inkludiert? Welche spezifischen Untersuchungen bietet das Years Medical Center zur Lungenfunktion und kardiologischen Diagnostik an? Welche sensorischen und körperlichen Tests sind Teil des Diagnostikprogramms, und wie werden diese evaluiert? Wie wird im Years Medical Center die mentale Gesundheit der Patient*innen im Rahmen der Diagnostik berücksichtigt? Welche bildgebenden Verfahren wie Ultraschall und MRT kommen zum Einsatz, und welche Diagnosen lassen sich damit stellen? Welche Rolle spielt die genetische Analyse im FRONTIER-Paket, und welche prädiktiven Informationen werden daraus gewonnen? Wie wird die Liquid Biopsy als Methode zur Krebsfrüherkennung in die Diagnostik integriert und bewertet? Welche personalisierten Ernährungsempfehlungen und sportlichen Leitlinien resultieren aus den diagnostischen Verfahren? Welche Schritte unternimmt das Years Medical Center, um Präventivmedizin für eine breitere Bevölkerung zugänglich zu machen?   Weitere Informationen zu Dr. Jan Hennigs und dem Years Medical Center findest du hier: https://www.years.co/   Du interessierst dich für Gesunde Langlebigkeit (Longevity) und möchtest ein Leben lang gesund und fit bleiben, dann folge mir auch auf den sozialen Kanälen bei Instagram, TikTok, Facebook oder Youtube. https://www.instagram.com/nina.ruge.official https://www.tiktok.com/@nina.ruge.official https://www.facebook.com/NinaRugeOffiziell https://www.youtube.com/channel/UCOe2d1hLARB60z2hg039l9g   Disclaimer: Ich bin keine Ärztin und meine Inhalte ersetzen keine medizinische Beratung. Bei gesundheitlichen Fragen wende dich bitte an deinen Arzt/deine Ärztin.   STY-161

In this episode of Onc Now, Jonathan is joined by Dr Dave Cescon, a Medical Oncologist and Clinician Scientist at the Princess Margaret Cancer Centre, Toronto, Canada. Together, they explore the transformative impact of CDK4/6 inhibitors, challenges in liquid biopsy research, and the potential of mRNA vaccines in oncology.  Timestamps: (02:44) -Swimming in Toronto: Competitive vs. Open Water  (08:06) -From Internal Medicine to Breast Cancer Research  (14:09) -Translational research and circulating tumour DNA  (19:53) -The role of CDK4/6 inhibitors in breast cancer  (29:04) -FDA approval of ribociclib for high-risk early breast cancer  (31:45) -The future of mRNA vaccines for personalised cancer care  (37:34) -Dave's research challenges and innovations  (39:13) -Three wishes for healthcare 

In this episode of the Radiology Podcast, Dr. Lauren Kim speaks with Dr. Lama Dawi about a groundbreaking study comparing liquid biopsy and CT imaging in assessing tumor burden. They explore the strengths, limitations, and future of liquid biopsy in cancer diagnostics and precision medicine. Can it replace CT scans? Liquid Biopsy versus CT: Comparison of Tumor Burden Quantification in 1065 Patients with Metastases. Dawi et al.Radiology 2024; 313(2):e232674. 

Deepdive zum Thema Liquid Biopsies mit Prof. Nikolas Stoecklein, Leiter des Bereichs experimentelle chirurgische Onkologie am Universitätsklinikum Düsseldorf. Was genau ist eine Liquid Biopsy? Welche Rolle spielen Tumorzellen oder Tumor-DNA im Blut bei der Früherkennung und Diagnose von Krebs? Könnten Liquid Biopsies zukünftig die herkömmliche Krebsdiagnostik ersetzen? All das und vieles mehr erfährst du in dieser Episode! 00:00:00 Intro 00:45:00 Definition Liquid Biopsies 00:02:00 Anwendung bei Krebserkrankungen 00:03:45 Tumormaterial im Blut 00:08:00 zirkulierende Tumorzellen 00:13:00 zellfreie DNA 00:15:00 Pränataldiagnostik 00:16:30 Lungenkrebs 00:20:00 Prostatakrebs 00:24:00 Therapiesteuerung durch zirkulierende Tumorzellen 00:27:30 Früherkennung 00:30:00 Epigenetische Muster: DNA-Methylierungen 00:31:00 Stärken & Schwächen von verfügbaren Tests 00:36:00 GRAIL Galleri Test 00:39:00 Künstliche Intelligenz 00:44:00 Rezidivprognose bei Darmkrebs 00:49:00 Zusammenfassung und abschließende Worte Instagram: ⁠⁠⁠⁠https://www.instagram.com/med.alessandro/⁠ Youtube: https://www.youtube.com/channel/UCSusVamtMAp5WTumwU-dRiw Website von Prof. Stoecklein: https://www.uniklinik-duesseldorf.de/patienten-besucher/klinikeninstitutezentren/klinik-fuer-allgemein-viszeral-und-kinderchirurgie/forschung/experimental-surgical-oncology-ag-stoecklein/team LinkedIn von Prof. Stoecklein: https://www.linkedin.com/in/nikolas-stoecklein-4842173a/?originalSubdomain=de European Liquid Biopsy Society: https://www.uke.de/english/departments-institutes/institutes/tumor-biology/european-liquid-biopsy-society-elbs/index.html

In today's episode, we had the pleasure of speaking with David R. Gandara, MD, about biomarker testing in lung cancer. Dr Gandara is the chief medical officer of the International Society of Liquid Biopsy, the co-director of the Center for Experimental Therapeutics in Cancer, and the senior advisor to the director at the University of California Davis Comprehensive Cancer Center in Sacramento, and an adjunct clinical professor in the Translational and Clinical Research Program at the University of Hawaii Cancer Center in Honolulu.  In our exclusive interview, Dr Gandara discussed the optimal use of liquid biopsy for patients with non–small cell lung cancer (NSCLC), the ins and outs of testing for KRAS mutations, and available treatment options for patients with KRAS-mutant NSCLC.

Modern science, especially in the genetic and molecular biology spaces, generate vast amounts of data, and require vast amounts of data to be generated for thorough analysis. For example, finding a rare gene mutation such as BCR-ABL as a biomarker for chronic myeloid leukemia is like searching for a needle in a haystack. For a situation like this, dPCR is an ideal method, but high-throughput automation is also needed.Dr. Clarence Lee, Senior Product Manger at Thermo Fisher Scientific, tells how the QuantStudio™ Absolute Q™ AutoRun dPCR suite helps make the benefits of digital PCR available in an easy-to-use high-throughput system. The conversation covers how automation benefits are provided by MAP16 plates, system software, and the AutoRun plate hotel and loading robot. Clarence also talks about customer applications where he sees automation like this being applied to innovate and drive science forward. In the career corner portion, we learn about Clarence's journey from chemist and biophysicist, to roles in industry and his current role as a product manager. He shares what he loves most about his job and what he's most proud of over his career that has spanned several diverse roles. Visit the Absolute Gene-ius pageto learn more about the guests, the hosts, and the Applied Biosystems QuantStudio Absolute Q Digital PCR System. 

On this week's episode of the Balancing Chaos Podcast, Kelley sits down with certified brain-health coach Kayla Barnes to discuss all things biohacking, brain health and how we can live as long and as well as possible. Kayla is an entrepreneur and biohacker with a mission to help her clients and community achieve optimal health through science and research-backed approaches. Kayla has been named one of the top longevity leaders globally and has been featured in Forbes, Thrive Global, Byrdie and more. Barnes has a background in nutrition, has trained under the renowned brain doctor, Dr. Daniel Amen, and is the owner of the wellness space LYV. Through their conversation, Kelley and Kayla dive into the latest science-backed wellness tools to elevate cognitive function and eliminate brain fog. By understanding the way hormones and gut health play a role in brain health, we can optimize the way we think and feel by harnessing the power of those connections. From what testing you should be doing on your gut, hormones and brain to the best diet for brain health and how to lower your toxic burden and which biohacking tools are actually worth the money and time, we go over everything you've ever wanted to know about brain health, mood, and mental health.To connect with Kelley click HERETo book a lab review click HERETo connect with Kayla click HERE

In this episode, listen to Alice T. Shaw, MD, PhD, and Jessica J. Lin, MD, share their thoughts on the current understanding of ROS1 rearrangements in non-small-cell lung cancer tumor biology and its implications for molecular testing and treatment selection including:ROS1-gene fusions in advanced lung cancerROS1 testing recommendations with DNA NGS, RNA NGS, FISH break apart assay, and IHCComparative specificity of ROS1 and ALK targeting tyrosine kinase inhibitorsAdvantages of RNA- vs DNA-based next-generation sequencing Program faculty:Jessica J. Lin, MDAttending PhysicianMassachusetts General HospitalAssociate Professor of MedicineHarvard Medical SchoolBoston, MassachusettsAlice T. Shaw, MD, PhDChief, Strategic PartnershipsAttending Physician, Thoracic OncologyDana-Farber Cancer InstituteHarvard Medical SchoolBoston, MassachusettsResources:To download the slides associated with this podcast discussion, please visit the program page

In this episode of the Veterinary Cancer Pioneers Podcast, Dr. Rachel Venable interviews Dr. Heather Wilson-Robles, Chief Medical Officer at Volition Veterinary and a seasoned veterinary oncologist with a rich history spanning academia and industry. Dr. Wilson-Robles shares insights on the crucial role mentorship has played throughout her career, starting from her early exposure to pediatric oncology, which led her to veterinary oncology. She discusses the significant impact that mentor-mentee relationships have had on her personal growth and professional development. The episode offers a deep dive into Dr. Wilson-Robles's contributions to the field and her ongoing efforts to advance veterinary oncology.

In this episode, Dr. Geo engages in a detailed discussion with Dr. Eric Klein, a leading expert in prostate cancer. They delve into the genetics behind prostate cancer, exploring genetic predispositions and the mechanics behind genetic mutations. The conversation highlights the emerging role of liquid biopsies in detecting and monitoring prostate cancer, with Dr. Klein explaining the potential of next-generation sequencing in identifying DNA mutations and cancer signals in the bloodstream. They also discuss the utility and limitations of tests like Gallery's GRAIL and the influence of methylation and gene mutations on cancer behavior. Emphasis is placed on understanding cancer biology for more targeted treatment, integrating biologic signals with clinical staging systems, and the future implications for patient care and treatment monitoring. Tune in for an in-depth look at how genetics and innovative technologies revolutionize prostate cancer diagnosis and treatment.-----------Thank you to our sponsors.This episode is brought to you by Mr. Happy products-formulated by Dr. Geo Espinosa, these products address age-related health concerns like BPH and declining sexual health. By boosting nitric oxide levels and providing antioxidant support, Mr. Happy products help improve cardiovascular health, energy levels, cellular health, sexual health, mood, and stress levels. Experience the benefits of Mr. Happy products and visit > IamMrHappy.com This episode is also brought to you by AG1 (Athletic Greens). AG1 contains 75 high-quality vitamins, minerals, whole-food sourced ingredients, probiotics, and adaptogens to help you start your day right. This special blend of ingredients supports your gut health, nervous system, immune system, energy, recovery, focus, and aging. All the things. Enjoy AG1 (Athletic Greens).----------------Thanks for listening to this week's episode. Subscribe to The Dr. Geo YouTube Channel to get more content like this and learn how you can live better with age.You can also listen to this episode and future episodes of the Dr. Geo Podcast by clicking HERE.----------------Follow Dr. Geo on social media. Facebook, Instagram Click here to become a member of Dr. Geo's Health Community.Improve your urological health with Dr. Geo's formulated supplement lines:XY Wellness for Prostate cancer lifestyle and nutrition: Mr. Happy Nutraceutical Supplements for prostate health and male optimal living.You can also check out Dr. Geo's online dispensary for other supplement recommendations Dr. Geo's Supplement Store____________________________________DISCLAIMER: This audio is educational and does not constitute medical advice. This audio's content is my opinion and not that of my employer(s) or any affiliated company.Use of this information is

When you have a good thing going you often want it to last forever, but we know that can never happen. Life and the world around us are fluid, dynamic, and we're always finding the balance of fighting or harnessing entropy and inevitable change.As we encounter unexpected changes, we see them as chances to evaluate the foundations of our podcast's success while finding opportunities to evolve it and make it even better. Join us for a reflection of where we are, how we got here, and a sneak preview at what's to come. We're here to assure you, evolution is a good thing!

In this day and age, young people are now getting cancer at a tremendous rate.A constant worry in all our families is the fear that a family member - old or young - would suddenly emerge as someone who is battling the late stages of cancer. This would usually lead to thousands of dollars availing of treatment for an illness that's already widespread within the body without assurance that the cancer cells will be depleted in the body enough to consider the individual recovered. With that in mind, Quantgene is setting a new standard in the medical field as they conduct liquid biopsy partnered with the DNA Company's genomic tech.In this episode, Tracy Wood, CEO of the DNA Company, along with Dr. Krista Kostroman, CSO of the DNA Company, is joined by Jo Bhakdi, CEO of Quantgene. The trio discuss the importance of preventive care, most especially when it comes to talks of cancer detection. As mentioned in the former paragraph, it is better to detect cancer in its early stages to ensure that it doesn't come to a point where it has overtaken the body. They discuss what liquid biopsy is and its benefits when individuals invest in such tests. The episode also tackles what steps must be taken beyond detection. This means making an effort in conducting lifestyle changes and strategic prevention to take a stand against the war on cancer while all is not lost, and there's still hope.If you wish to learn more from Jo Bhakdi and Quantgene, you may do so through the following links:Jo Bhakdi's Instragram account at https://www.instagram.com/jobhakdi/Quantgene's website at https://quantgene.com/Quantgene's Instagram Account at https://www.instagram.com/quantgene/▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Keep yourself up to date on The DNA Talks Podcast! Follow our socials below:The DNA Talks Podcast Instagram https://www.instagram.com/dnatalkspodcast/Dr. Krista Kostroman's Official Instagram Page https://www.instagram.com/drkostromanofficial/This episode may also be viewed on YouTube▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Music: Inspiring Motivational Background by Stock-Waveshttps://www.stock-waves.com/https://protunes.net/Video Link:  https://www.youtube.com/watch?v=pbwVDTn-I0o&list=PLQtpqy3zeTGB7V5lkhkfBVaiZyrysv_fG&index=5▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Music: Peaceful Corporate by Stock-Waveshttps://protunes.net/Video Link:  https://www.youtube.com/watch?v=I34bTKW8ud0&list=PLQtpqy3zeTGB7V

KSQD 5-01-2024: This week's show explores how healthcare systems can inflict "moral injury" on dedicated doctors. We examine instances where factors like insurance company prior authorizations prevent optimal patient care and discuss related research. Dr. Dawn explores sweetness perception, reviewing a new study on how our bodies detect both natural sugars and substitutes like xylitol and stevia. We learn how substitutes can provide sweetness without insulin spikes and subsequent appetite increases. We discuss the critical importance of measles vaccination, the challenges of maintaining live virus vaccine potency, and a promising new vaccine technology undergoing trials. A new study investigates the potential benefits of combining time-restricted eating with high-intensity exercise. Although all participants lost weight, the combined approach led to gains in lean body mass. Finally, we survey several exciting advances in cancer research. Dr. Dawn explores improvements in cancer cell targeting, the statistics of liquid biopsies for cancer detection, and a groundbreaking drug that halts aggressive breast cancer growth. We also investigate a new mRNA-based treatment that stimulates cancer cell death specifically within the tumor environment.

An opportunity to detect pancreatic cancer at stages where early intervention can greatly extend life and even make cure possible seems to be on offer, according to findings from a study of a new liquid biopsy method based on so-called exosomes: subcellular molecules shed into the circulation by cancer cells. At the AACR Annual Meeting 2024 in San Diego, Peter Goodwin talked with Ajay Goel, PhD, AGAF, senior author of the study and Chair of the Molecular Diagnostics and Experimental Therapeutics in the Beckman Research Institute at City of Hope in Los Angeles.

AI and predictive modeling to understand an individual's immune system function and predict treatment response are still in very early stages. We dream about precision medicine and getting every answer we can for ourselves when we get sick. However, if we look at genomics, only about 20 percent of human coding genes are well-studied. The remaining 80 percent (about 16,000 genes, along with the proteins they make) are largely a mystery.  In this episode, you will hear more about the field of immuno-oncology, understand the correlation between tumor development and immune system response, and trends in cancer detection and prevention, especially liquid biopsies - tests for detecting tumors in blood samples.  Speaker: Brian Hashemi - Executive Chairman and CEO of Novigenix - a Swiss-based biotech company using AI and RNA sequence analysis to capture the cancer immunity cycle during the multi-stage disease progression and response to therapy. www.facesofdigitalhealth.com https://fodh.substack.com/ Show notes: [00:02:00] The use of AI and RNA sequence analysis in capturing the cancer immunity cycle and disease progression [00:04:00] Biotech in Switzerland [00:06:00] The impact of Swiss biotech capabilities on global healthcare and the specific advancements made by Swiss companies in the field. [00:08:00] Predictions and hopes for the future of healthcare technology, especially in the realms of cancer detection and treatment. [00:10:00] Challenges and opportunities in biotech, and the role of AI in advancing healthcare. [00:12:00] Challenges in Colorectal Cancer Screening [00:14:00] The Impact of Liquid Biopsy on Clinical Trials and Drug Development [00:16:00] Market Adoption and Patient Accessibility to Liquid Biopsy Tests [00:18:00] The Future of Liquid Biopsy and Precision Medicine [00:20:00] Real-world Application and Impact of Novel Biomarkers [00:22:00] Expanding the Reach of Novel Diagnostics Beyond Switzerland [00:24:00] Partnerships and Collaborations to Accelerate Adoption

Erhalten Sie heute faszinierende Einblicke in die ⚕️ Zukunft der Krebsbehandlung und die Rolle der ⚕️ personalisierten Medizin. Willkommen zu einer neuen Episode unseres Podcasts, in der wir das Vergnügen haben, mit

JCO PO author Dr. Christian Rolfo shares insights into his JCO PO article, “Liquid Biopsy of Lung Cancer Before Pathological Diagnosis Is Associated With Shorter Time to Treatment.” Host Dr. Rafeh Naqash and Dr. Rolfo discuss how early liquid biopsy in aNSCLC in parallel with path dx is associated with shorter time to treatment. TRANSCRIPT  Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCOPO articles. I'm your host, Dr. Rafeh Naqash, Social Media Editor for JCO Precision Oncology and Assistant Professor at the Stephenson Cancer Center, University of Oklahoma.   Today we are thrilled to be joined by Dr. Christian Rolfo, Associate Director of Clinical Research at the Center of Thoracic Oncology at the Tisch Cancer Institute at Mount Sinai Health System. He is also the lead author of the JCO Precision Oncology article entitled "Liquid Biopsy of Lung Cancer Before Pathological Diagnosis is Associated with Shorter Time to Treatment."  Our guest's disclosures will be linked in the transcript.  Christian, it's great to have you here. Welcome to our podcast and we are excited to learn about some of the interesting results from your study.  Dr. Christian Rolfo: Thank you very much, Rafeh. It's a pleasure to be here and discuss about liquid biopsy. Dr. Rafeh Naqash: You have a very important role in different liquid biopsy consortiums. This is an initiative that you have been leading and spearheading for quite a while, and it's nice to see that it is becoming something of a phenomenon now on a global scale where liquid biopsies are being implemented more and more in earlier stages, especially. For the sake of our audience, which revolves around academic oncologists, community oncologists, trainees, and patient advocates or patients themselves, could you tell us a little bit about the background of what liquid biopsies are? And currently, how do we utilize them in the management of lung cancer or cancers in general? Dr. Christian Rolfo: Liquid biopsy has been gaining importance over the years. We started to talk about liquid biopsy in 2009 when we started to see some correlations with EGFR mutations. In practicality, what we are doing is the most common or most applicable indication is to go for liquid biopsies from the blood, peripheral blood. So we are doing a blood draw and from there, what we are capturing is the DNA or fragments of DNA that are still in circulation. But the liquid biopsy definition is a little bit more broad and we can apply the concept of a minimally invasive approach to different fluids of the body, including pleural effusion, urine, and including CSF that is another indication, there, we are going to be a little bit more invasive than peripheral blood, but it is also an emerging tool that we will have to find specific indicators. In cancer, we started the history of liquid biopsy in advanced disease with the identification of biomarkers, and then from there, we are moving to other scenarios, including, nowadays, monitoring minimal residual disease and early detection. And that is applicable also for other tumors. Dr. Rafeh Naqash: Thank you, Christian, for that summary. Now, as you've rightly pointed out, we have come to implement liquid biopsies more and more, both in the academic setting and the community setting. And this has definitely led to faster turnaround time in some ways compared to tissue. In this study that you have authored with the help of many other collaborators and Foundation Medicine Flatiron Health data, the goal here, from what I understand, was to look at liquid biopsies that were done before, resulted before the pathological diagnosis. Could you tell us a little bit more about the premise of this study, why you thought about this question and how did you try to implement that idea to get to some of the interesting results that you see here? Dr. Christian Rolfo: Yeah, so what we are seeing generally in lung cancer and also in people with other tumors is that patients are having a journey and that they start seeing different doctors until they get a diagnosis. Generally, after the pathological diagnosis, if you don't have an in-house technology that is doing reflex testing, generally, oncologists need to request for testing and that is taking time. So if we are looking for comprehensive days until a patients are able to get a molecular profiling before we start the treatment is sometimes very long. We are talking, in some cases, about months. So, how we can speed the process, that was the main question. We tried to include liquid biopsy in the staging procedures that we generally were doing when we have a clinical diagnosis of lung cancer. It's either images that we are used to do, PET scans, MRIs, and other assessments, we want to include liquid biopsy there before the biopsy. And that's what we did. We were searching for this specific aim using the Flatiron Health Foundation Medicine electronic health records from 280 centers across the United States. We included a big number of patients in this analysis, more than 1000 patients for the first analysis. Dr. Rafeh Naqash: That's phenomenal that you had real-world data from 200+ centers across the US. Of course, when you have patients on a clinical trial versus patients in the real-world, we all know that there are differences in terms of approaching, overseeing, and managing these individuals. So this data set is an extension of what we could see in the real-world setting.  Could you tell us a little bit about the number of patients that you eventually identified that had liquid biopsies done before pathological diagnosis? I think you have different cohorts here, a group that was before and a group that was after, and you compared several important metrics treatment-wise from what I see. Could you highlight those for our listeners? Dr. Christian Rolfo: Yeah. So we were looking for patients who had a liquid biopsy CGP, comprehensive genomic profiling, ordered within 30 days pre diagnosis and post diagnosis. We focused on 5.2% of patients, which corresponded to 56 patients who ordered a liquid biopsy before diagnosis. The median time was eight days between the order and diagnosis and the range was between 1 to 28 days. And that was compared with 1020 patients who ordered a liquid biopsy after diagnosis. It is important to be clear that both cohorts had a similar stage and ctDNA tumor fraction. We can explain later what tumor fraction is, because it was done in addition with a paper that we just published last week. Liquid biopsy patients were consulted to have this CGP median one day after diagnosis, versus 25 days after for patients who had their diagnosis and their liquid biopsy later on. So, from these patients, the majority of the patients, 43% of LBx-Dx were positive for an National Comprehensive Cancer Network driver, and 32% had ctDNA TF >1% but were driver negative, so that is what we call presumed true negative. From here, maybe I can explain what is tumor fraction and, in general, how we use it.  Dr. Rafeh Naqash: I think that would be great for our listeners. We see this often in more and more liquid biopsy results nowadays, and I've tried to explain it to some of my fellows also. So, it would be nice if you explain for the sake of our listeners what tumor fraction is, what does it mean clinically, can you use it in a certain way, what biological relevance does it have. Dr. Christian Rolfo: So we are analyzing another paper that came out this week in cancer research on the concept of tumor fraction and it's a new definition. So what we are doing with tumor fraction is an algorithmic calculation or mathematical calculation on the amount of DNA of the cells also taking into consideration the math, the quantity of DNA present in the sample. So we are going very low in the sensitivity of this analysis and capturing there the real informative results of the ctDNA of the liquid biopsy. So in practicality, when you see a report that says the threshold that was established in this study was more than 1% or less than 1%, so patients who have a tumor fraction of more than 1%, we can really consider this liquid biopsy informative. And also in this next publication, we compared with tissue. In patients with a tumor fraction of more than 1%, were completely 100% correspondent with what we found in the reflected tumor tissue, the NGS. But what happened in patients with a tumor fraction of less than 1%, we can say that these patients are not informative. So we need to wait for the tissue biopsy result to come in because we were able to recuperate several patients that the liquid biopsy was negative with the tissue biopsy positive. This is an important concept because we are distinguishing not only the informativeness of liquid biopsy, but also we can distinguish between patients who are considered not shedder based on what is considered a shedder. And that was a problem until this kind of introduction was a problem before with the technology because the technology wasn't very fast to distinguish the sensitivity or high sensitivity. Now, the sensitivity is no longer a problem. Maybe, there is really value of information in what we have in liquid biopsy, and using this mathematical help, we can get these patients distinguished and help more people. So that would be really interesting. Dr. Rafeh Naqash: You touched on a few important concepts here, and one question I have, and I think there's no better person to answer this question. You're the right person to answer this question for our audience. Do you think when you have a liquid biopsy tumor fraction of less than 1%, and you have a tissue that is pending with an NGS, where tissue NGS has not resulted yet, but liquid biopsy results come in and tumor fraction is less than 1%. But let's say you have a non-smoker with a typical driver mutation and clinical characteristic positive individual in the clinic, and the tumor fraction is less than 1%. How much can you trust that liquid biopsy when the tumor fraction is less than 1%. Because do you think some of these driver mutations, like you mentioned, could be low shedders and you could miss a potentially actionable mutation on a liquid biopsy if the tumor fraction is less than 1%? Is that something that you've looked at or correlated or understood what would be the clinical meaning of that? Dr. Christian Rolfo: Absolutely. So there are two concepts here. A liquid biopsy could be non-informative, and that is what we saw in this paper. So you have patients that have a liquid biopsy negative, and that we see in the clinic, a liquid biopsy negative tissue biopsy positive. That could be because the liquid biopsy is not informative, but it could be also that the patient, for some biological reason, and we don't have an answer about that, they are not shedding the ctDNA in the bloodstream, ctDNA that we can capture. What we saw in different studies, including one of the papers that we presented also in ASCO last year with a MET amplification and  METex14, for example. In the study that was the VISION study using tepotinib, you see that patients who have a liquid biopsy negative are doing a better outcome compared to a patient who have a liquid biopsy positive. So I believe that we still have patients who are not shedders for some biological reason, that could be put in together with patients who have more bone metastasis than organ metastasis, or patients who have more in location, for example in the brain. These patients are difficult to capture in ctDNA due to some biological reasons. But also you have patients who are non-shedders. For the technicality of the parts of this tumor fraction analysis, it is really important to distinguish that and we will hear more and more. So, as you say, we have already some reports in some companies like Foundation are doing, but some others like to incorporate this tumor fraction. And several in-house technologies allow also to have this kind of mathematical calculation. So that is what we are facing now, to really understand better the power of liquid biopsy. Dr. Rafeh Naqash: Now, some of the other things that your project or paper that you published with JCO PO does not necessarily cover is the payer aspect of this. Now, we've had more and more discussions, obviously, and more and more information has been highlighted with the payers that this is an important test and needs to be reimbursed, even though if you do tissue NGS, liquid biopsies are complementary to tissue. So taking both together is probably a better view of the overall tumor or the mutational status of the tumor. But one of the biggest holes in this whole process, and this is my personal experience, I want to know what you think, is that we can't order these tests when the patient is admitted to the hospital, and 50% or more patients end up getting diagnosed in the hospital during an inpatient stay. The average hospitalization for someone with lung cancer is five to seven days on average, and then another one to two weeks to get into the clinic to see an oncologist. So what would your thoughts be there? How can we improve things there in terms of, can we try to do something different so that the payers agree that, yes, you can send a liquid biopsy when the patient is admitted, because there's that 14-day Medicare rule? Has your team, or have you in particular, tried to navigate some of those issues, and what are your thoughts on how we can try to improve some of those conversations?  Dr. Christian Rolfo: Yeah, that's a really good question, because here we are talking about inequities in access to the technology and the results and it's crucial. Several of our patients, specifically in lung cancer, they are coming to our consultations or to the emergency with a very bad situation so they need to be admitted immediately. And as you say, they can be there for one month waiting for results or for recovery or for stabilization of their general condition before we can start. Several of these patients will have some biomarkers that we can target with treatment. So in other words, I will say that this is a stupid rule because we cannot have in 2024 these kinds of limitations to access to treatment when we have on one side, the FDA is doing a terrific job to get drugs approved in a very short time, and on the other side we have payers who are not understanding the concept of molecular or precision oncology.  So what we are trying to do in these cases, to be honest, is to navigate with the vendors and try to get this done. I generally send the samples because I consider that personally that it is a very crucial information. And in several cases, we have started targeted therapies while the patient is still admitted. So I think it's something that we need to put in a better effort, because already we are not doing enough for our patients, if you look at the data of the MYLUNG Consortium that was presented in ASCO some years ago on the testing performance in the community practice, 50% of the patients with lung cancer were tested there were only some in minority groups, African Americans, 39%. So I think we need to do better in education, but also from the payer side, it's really crucial that they understand this concept.  Advocacy groups have a lot of say here. They are also doing an important job on that. We are now launching with ISLC, ISLB, Lung Cancer Europe, and Longevity in a survey that is to make also the patients aware what is the importance of molecular profiling, tissue or liquid biopsy, it's very important that you get something to treat the patient and select the right treatment. And even to say, there'll be a whole other work in your case so that is really important.  Dr. Rafeh Naqash: Absolutely, I completely agree. We have made a lot of strides, but there is still a lot of room for improvement in terms of equity, access, and reimbursement.   Now, one of the things that I noticed in your paper, and you could tell me a little bit more about this, when you looked at the pre-diagnosed liquid biopsies, meaning before tissue diagnosis, 56 individuals there suspected to have lung cancer, community-based testing was identified in 53 individuals versus academic being three. This is very encouraging when you see something like this happening in the community. Did you look at that? Did you try to understand why or how that was the case? Because in a general community setting, I would think that community practices have a more complicated system of reimbursement because they are dependent on direct reimbursement, whereas in bigger academic centers, there's some leeway here and there. So did you try to understand how they were able to order this before tissue, could you give us some insights there? Dr. Christian Rolfo: Yes, I think it was not big in this specific question, but it's a very interesting topic. Because we, generally, in academia, will believe that we are doing the things in advance and we are more, compared with the practical and the general practitioners or the general colleagues in the community practice, we have more resources. But sometimes, and it's true, obviously, we have more resources in terms of research and more opportunities in terms of clinical trials in some cases. But I think we understood with this minimal example that there is an important interest among general oncologists in the community practice to get this done. And this is something we need to emphasize, because sometimes we are putting the blame on our colleagues that are outside the academic centers on this lack of testing, and it's not really true sometimes. So this is a good point to start to work together and try to get more things done for our patients and try to get also the reality.   I think one of the problems we will have in the future that we can face right now is the lack of new figures in this molecular profiling. I am referring, for example, molecular nurses or personnel that is working and helping to get this done. We need to have more people that are working in this education for the patients in the access to treatment and access to the technology, but also to navigate better these problems with payers that sometimes in some patients that seem to be overwhelming. Because when you talk about the $100 that could be extra, it's hard for some patients. So we need to be very conscious about that. So having a new figure in the hospitals and the community practices could help to test more patients.  Dr. Rafeh Naqash: And I think at the end of the day, the payers or the reimbursement mechanisms need to understand that genomics is part of the diagnosis these days. It's not ancillary, it's not an addition, but it is part of the diagnosis. I'm pretty sure you have had similar instances where you get a confusing pathology result but then a genomic result points in a certain direction. You treat the patient in that direction, and then you see the patient benefiting in the tumor shrinking, which suggests that genomics is complementary to the path diagnosis. It's not necessarily a surrogate.You can't replace pathological diagnosis, but you can use genomics as a complementary diagnosis as part of the whole paradigm of treating the entire patient. So I think we definitely need more and more conversations like the ones that you're having or your liquid biopsy consortium is having and then more education from the FDA. Of course, more legislation, more advocacy.   Going back to the paper, I did notice another interesting thing, which is, again, very encouraging is patients with lung cancer with a performance status of 2 or about had a decent proportion of testing done. Which, again, points out to the important concept of avoiding these preconceived biases that, “Hey. If somebody is not a great performance status, testing and finding something in that individual could potentially change a lot for the individual.” Do you have any personal examples from patients you have treated or seen in the clinic for our listeners where you identified something and maybe they were not doing as great initially, and then you identified something in liquid biopsy, treated them and it changed the entire course of their illness and whole trajectory for them? Dr. Christian Rolfo: Being working in lung cancer for years, everyone has this kind of patient that we see that their performance state was very bad. Obviously, as a clinician, we need to identify why the performance is bad and is deteriorating. So we see some patients in lung cancer, some of them, they can have a very important comorbidity packet that is associated with lung cancer. So in patients who have a deterioration for lung cancer, and we find a driver help in some patients that were doing a kind of a weakness, and that is something that we see in several patients, specifically in patients living with leptomeningeal disease. In some cases, when we start to do drivers that have a big impact in the crossing the blood-brain barrier, I have a good response.  I have patients that had an important recovery. So this is something we need to distinguish and sometimes when the patients seem very bad they say, “Okay, we go directly to targeted care or supportive care.” We try to test these patients as well because these patients have an important impact on the quality of life that we are treating. We will not be able to cure patients in this setting with targeted therapies, but we can certainly make an impact in the quality of life and also in our form of survival.  Dr. Rafeh Naqash: One of the other questions that comes up often when you're in a multi display team, since most cancers these days are on the multi display decision making opportunities to treat the patient the best possible way is: Who orders the liquid biopsy? I remember from my fellowship several years back, our program director Paul Walker, who is, again, an amazing lung cancer thoracic oncologist, he had advocated that our endoscopic suite folks, the bronchoscopist, whether it was pulmonary, interventional pulmonology or CT surgeons, whoever did the bronchoscopy for the first time in the patient that they would send it whenever they see the patient from the bronchs. This was around six, seven years back. And I think Paul was a little ahead of his time and I didn't necessarily understand the implications that this would have.  And now, as I progress in my own little career, I can see the vision that he had, which I think a lot of other sectors have tried to do, and I'm pretty sure you have a certain process, too. Is that something we should try to talk more and more about? Because, of course, when you do the bronch, then you get a diagnosis and the patient sees the oncologist. This whole process takes anywhere from two to three weeks, maybe even more for smaller centers. So, is that something that you're doing or you see that you're having more conversations that, “Hey. Whoever sees the patient first should be able to order the liquid biopsy.” It's not necessarily the medical oncologists, it doesn't mean I love to order sequencing results or  sequential tests, but it could cause a delay in the patient care. So, could you tell us a little bit more of that?  Dr. Christian Rolfo: So it's really important, this part, because we need to create in our institution flows that will have this very well organized. And ideally, in the ideal world will be that we have reflex tests coming from the pathologist, but it's not happened in several places, because we don't have our NGS at home, or we are sending to vendors, and sometimes we are not sending to them. So that is one of the aspects.  The second aspect, and that I think is still a problem in some treatment, is that we still have 24:30 cytologists coming out in place of covariances. And in our institution, we were working very hard with our interventional pulmonologists and interventional radiologists to get this quality of tissue appropriate, and we have a very good rate of success and issues in a very minimal quantity of patients. Obviously, some patients are very difficult to get samples, and we need to refer still with cytology. But in some cases, where our surgeons or our pulmonologists have sent in samples for NGS, and I think this is we are coordinating. “I will see this patient next week. Can you please start to order?” And here, our nurse practitioner, our nurses in the team are also playing an important role for the reason I insist in the idea to have new figures that could be these molecular navigators we can call, or molecular nurses that helping coordinate this, not only the coordination, but also in the discussion of molecular tumor boards. We did an experience like that some years ago at Maryland University, and actually it was a very important opportunity to decrease the number of quantities of issues and get the results done very quickly. So I think it's important to come to have conversations with our colleagues, pulmonologists, radiation radiologists, interventional radiologists, pulmonologists and pathologists to get this done very quickly.  Dr. Rafeh Naqash: I love the idea of molecular navigators. And of course, everybody in the current day and age, we're having staffing issues, so getting a molecular navigator would be awesome, but I'm not necessarily sure how everybody would be able to implement it. But I think in the bigger picture, whether it's molecular navigators or multi disciplinary nurse navigators in general, liaisons in general, I think we all can do a better job in trying to coordinate some of these testings. And we have tried to do that through our thoracic oncology group and of course, there's a lot of progress that needs to be made, one step at a time. Dr. Christian Rolfo: If somebody is interested in this topic on the International Society of Liquid Biopsy, we started with a project that is called a Certificate for Advanced Studies in Precision Oncology. So we are educating the healthcare team for all this process and trying to get practical insights to have this career later. Because I think it will be something that's interesting for nurses or pharmacists to get this kind of career later or get another approach in their career.  Dr. Rafeh Naqash: Thank you so much, Christian.  Now, going to not the scientific part, which I think is the most interesting part of this conversation is to talk about you and your personal journey. Could you tell us a little bit about where you started, what your career has been like, how did you progress? Because you have a lot of junior faculty that listen to this and it's always good to take inspiration from people like yourself.  Dr. Christian Rolfo: Thank you. As you can hear my accent, it's not from here. So I was born in Argentina, I did my medical degree there. And then I had the opportunity to get a scholarship in Italy. I went to Italy and I stayed there for seven years. I did my fellowship there again, and I started to know there precision oncologists. My journey started in sarcoma. And actually I was working in the group of Dr. Casali's group, a very well known sarcoma expert. And at that time we were running phase I trials for imatinib, I remember, known as GIST. I saw this kind of response and awakening of patients that were really in very bad condition, with only through this imatinib. Very little to treat that disease at that moment, a median overall survival of two months. So I started to be interested in that. Then I moved from there to Spain and met Dr. Rafael Rossell, who was my mentor. In Italy, I have also a mentor in breast cancer, Dr. Luca Gianni, one of the pioneers in breast cancer treatment. So knowing all these people and having the support of them, was really crucial.  So I think this is the first advice for junior faculty: try to choose your mentor, even if your mentor is not in your center. Like the case, for example, Rafael Rossell was not in my hospital, but he was my mentor. So having this kind of discussion, I did my PhD in EGFR mutation, at that time was the fashion, not immunotherapy, of the moment. And then from there, after eight years in Spain, I moved to Belgium. I have a short period of completing my training at MD Anderson and I went to Belgium to Antwerp University and that was the opportunity to become the Director of the phase I program in the Early Clinical Trials Unit. It was really exciting to see growing a unit, and now they continue  at the center in Belgium. My colleagues that stayed there, they are doing a terrific job of continuing this idea. And from there I went to Baltimore, three years working at Maryland University being the Director of Thoracic Oncology and early clinical trials as well. Three years after, I moved to New York, and here doing this journey in clinical research, also being the Director of Clinical Research at the Center for Thoracic Oncology.  Life has put me in different places, different cultures, different opportunities. For me it was a really good journey to be in different countries, knowing different ways to see oncology as well, and immediately to work, because it was a shock coming from Belgium to the area of Baltimore where I had the reality to discuss peer to peer conversations and things that are not usually discussed in Europe. So it was really a very nice journey to learn, to have the capacity to adapt.  That is the other thing, my second advice, if I can give advice, but if you have the opportunity to go to some place, adaptation is the most important. So try to enjoy what you're doing and try to enjoy and learn from the patients, hopefully, and contribute your knowledge as well. Dr. Rafeh Naqash: Thank you so much, Christian. Two last questions. For all the places that you visited, what is your favorite place? And what is your favorite food? Dr. Christian Rolfo: My favorite place to live, I have Italy in my heart. Obviously, Argentina is my place, family. But Italy is in my heart. And then Spain, Spain gave me my wife and my son. So I have very good memories there and it's a very nice place. Obviously, I'm Argentinian, so for me it means meat in some places, Asado, that is a typical Argentinean one. But also, I am very eager to enjoy the pasta and paella, so we have several things. Anyway, here in New York, the pizza of New York is great. It is not Italian. This new way to make pizza from New York is fantastic.  Dr. Rafeh Naqash: I can try to see you're trying to keep everybody happy in a politically correct way. Dr. Christian Rolfo: I didn't mention Belgium, but we have chocolates there.  Dr. Rafeh Naqash: That is true. Every place is special and unique in different ways.  Christian, thank you so much. This was very entertaining and very informative for me and hopefully for the audience. Thank you so much for being a part of this conversation. And thank you so much for submitting your work to JCO PO. We hope you consider JCO PO for future research in this exciting area as well.  Dr. Christian Rolfo: Thank you. Thank you very much, Rafeh, for the opportunity. And JCO Precision Oncology is a really great forum to discuss precision medicine. Congratulations for all your work. The last, if you allow me to give an advertisement here. We have our Liquid Biopsy Congress, the ISLB, the annual conference will be in Denver from 20 to 25 November, so just before Thanksgiving day. So if you are able to go there, we will have a lot of discussion on liquid biopsy like we did today. Thank you very much.  Dr. Rafeh Naqash: Thank you so much for highlighting that, and hopefully, our listeners will try to register and be part of that meeting.  Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review. And be sure to subscribe so you never miss an episode. You can find all our shows at asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

JCO PO authors Lauren C. Leiman and Dr. Emma Alme share insights into their JCO PO article, “Recommendations for the Equitable and Widespread Implementation of Liquid Biopsy for Cancer Care”. Host Dr. Rafeh Naqash and guests discusses increasing access to liquid biopsy for cancer, reviewing the barriers and examining the proposed solutions. TRANSCRIPT Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, Social Media Editor for JCO Precision Oncology and Assistant Professor of Medicine at the OU Health Stephenson Cancer Center at the University of Oklahoma. Today, we are excited to be joined by Lauren Leiman, Executive Director of BloodPAC, and Dr. Emma Alme, Public Policy Director at Guardant Health. They are both authors of the JCO Precision Oncology article titled "Recommendations for the Equitable and Widespread Implementation of Liquid Biopsy for Cancer Care."  Our guest disclosures will be linked in the transcript.  For the sake of this conversation, we will refer to each other using our first names. So, Lauren and Emma, welcome to the podcast and thank you for joining us today. Lauren Leiman: Thank you for having us. Dr. Emma Alme: Thank you so much.  Dr. Rafeh Naqash: So, this article is an opinion piece that addresses something that is emerging and current and tries to connect it to something that is futuristic also and hopefully, will address a lot of different needs relevant to patients with cancer. For starters, since our audience is pretty diverse, could you tell us what the BloodPAC is? Since the article is somewhat a combined piece from different stakeholders, could you explain what this BloodPAC Consortium is as an entity and what is its role for this BloodPAC? Lauren Leiman: Sure, this is Lauren Leiman. The BloodPAC was formed almost seven years ago as an initial commitment to the White House Cancer Moonshot back in 2016. I was the head of external partnerships and had this idea with a colleague of mine, Dr. Jerry Lee: Could you accelerate the development and approval of liquid biopsy assays for cancer patient benefit if you were able to create some standards and frameworks for the field broadly, and also if you could aggregate data to support those standards and frameworks? So, we brought together about 20 different organizations across pharmaceutical companies, diagnostic partners, foundations funding in the space, government agencies, all to think through can we create these frameworks, are we willing to submit data. We were extremely successful in that first round, and by the end of 2016, we were able to have our first data deposit into- we built a BloodPAC Data Commons, which is housed in Chicago and was created by Dr. Bob Grossman up there. In 2017, when it became clear that the last administration was not going to continue the White House Cancer Moonshot, we became an independent non-profit 501(c)(3). And we have grown substantially since that time from those original 20 different organizations to about 66 different organizations today, across all those areas again, including today, payers, which is very exciting. And we have added on to our mission statement one word that we will discuss today, which is very exciting, which is “accessibility”. After our five-year anniversary and even slightly before then, we decided that we really feel that we have been able to contribute, as a community, to accelerating the development and approval of these tests. But, in actuality if we don't get them into patients' hands, what is the point of all of our hard work? So, we added the word "accessibility." Today, we have these 66 different organizations that collaborate, essentially, to compete. They're pulling together projects and deliverables in about ten different working group areas to contribute products to the liquid biopsy community to help accelerate those three things. Dr. Rafeh Naqash: Thank you for explaining that. That seems like a very important initiative.  Now, when you say that you're contributing data, does it mean that different companies and entities are contributing patient-level data so that you can pool that and assess what is the utilization, what is the utility, what is the payer-related aspects, coverage aspects. Is that all part of the initiative?  Lauren Leiman: It is. We started with the idea, which is kind of scary, I think, for a lot of different companies: Are you willing to submit your protocols essentially, pre-analytical data? I think, much to the FDA's surprise, I was kind of, “Of course, everyone should be willing to do this, they should absolutely do this, it'll be really exciting. Why wouldn't they?” And I think others were a little skeptical that these companies who are highly competitive including Emma's company, Guardant, would be willing to contribute data. And in fact, Guardant is probably one of the first ones, first two at the table to actually submit their data which was just extremely exciting. And the data was around mostly protocols and pre-analytical variables, what tube types are you using? As we moved on, our pharmaceutical partners did submit full clinical trials with deidentified patient data, which was extremely exciting.   Today, our Data Commons sits in two different areas or visibilities for our members. One is membership-only data that only our members can see, so have been been contributed by them potentially sometimes for certain projects we're working on. And then we also have an open segment of our Data Commons that's open to the public, that includes published data and studies that anyone can take a look at and see. Our goal is to continue to open up all of our data over time, so that anyone can take a look at it. We are, I think, the leading liquid biopsy repository.  As we move into the future though, I think because we are mostly an organization that has pharmaceutical companies and diagnostic partners, we are company driven, aggregating large sums of research data is not necessarily their goal. And so to try to identify an area of mutually beneficial interests for everyone, I do think that over the next year or two, you'll see a potential shift or pivot in the use of Data Commons to where the industry is today which is probably, hopefully a little bit more coverage focused. How do we pivot from being a source of aggregated research to a source of identifying and approving the value of liquid biopsy to the full community? And again, that's for the full spectrum all the way through payers and the coverage of these tests, which I do think would add a tremendous amount of value to everyone on the life cycle of this industry but would also add a tremendous amount of value for access in getting these tests into patients' hands.  Dr. Rafeh Naqash: Of course, you importantly covered a bunch of different concepts. One is data democratization, which is extremely important in the current day and age for different people in the public domain if they have access to data, they can do a lot of interesting and important things and add to the overall understanding of what we know or don't know in this space of liquid biopsy utilization. And then, of course, the aspect of disparities and coverage assessments.  Now, going to Emma, for the sake of our listeners, some of them are trainees, and many of them are oncologists, perhaps many are patients. What is the current landscape for liquid biopsies? Where do we use them, and what are the general approaches and principles of where things stand?  Dr. Emma Alme: That's a great question, and it really spans the cancer care continuum. And I think the space where it's most established is in the advanced cancer stage for therapy selection. So that's where we actually have some even FDA approved assays for liquid biopsy, with Guardant 360 test being one of them. It's comprehensive genomic profiling to identify actionable biomarkers to get patients on targeted therapy. So that's where it's really been integral to precision medicine. And we're seeing an increase in utilization of liquid biopsy as the technology becomes more established. It's not just in cases where tissue is insufficient now. Most recently, we've seen NCCN guidelines and non-small cell lung cancer change for concurrent testing for liquid biopsies. So that's been an exciting trend in adoption.   And then as you move across the cancer care continuum, there's residual disease monitoring and response, where we can actually use ctDNA to look at a patient's response to therapy, even after surgery - is there still ctDNA there? Instead of just having imaging as an option, we can actually look sooner to see how the patient is responding and if there is still cancer present. So that's a really exciting place where we're seeing growth in liquid biopsy. And then moving even earlier, before a patient even has cancer, there's a tremendous opportunity for liquid biopsy in early cancer detection. I think that's something that has been previously discussed on this podcast and we see it a lot in popular media. But it's not just for multi-cancer, we have the opportunity for single cancer as well liquid biopsy tests in cancer screening.  That's a really exciting space, really thinking about the accessibility of these tests. Because a lot of cancer screening modalities today are hard for a lot of patients to access. And it requires going to a medical facility. So if the first step is a blood test, that really opens that up to communities that traditionally have been left out of screening. So I think there's a huge opportunity there, not just when we're thinking about screening for cancers that don't have screening modalities currently, but also screening for those that do, where maybe a first non-invasive step can really open the door to patients who don't have access.  So it's a long answer to say that, really, it's across the entire cancer care continuum. We see a lot of opportunity here for liquid biopsy to be a way to advance the field but also increase access for patients who have been left out of precision medicine. Dr. Rafeh Naqash: I think access is definitely the focus here. And I can give you my example. So I do early phase drug development and I do a lot of research in liquid biopsies and ctDNA monitoring. In the center of care, I treat people with lung cancer also and there have been instances, probably about a year or a year and a half back, where a patient could not come to the clinic. The clinic wasn't done and on my to-do list for that individual patient, I put in ctDNA testing just to remind me when I see the patient, to get it done. But the patient didn't make it to the clinic. Surprisingly enough, mobile phlebotomy was available. And later I came to know that this is something that can be done and provided to the patient at their home and you can still get the same results, which was very surprising in a good way. And it did help in making some treatment decisions for some patients who, sometimes in a state like Oklahoma, which is where I am based, we have a significant rural population and people drive six hours for some of our trials, especially the early phase trials. And then if you tell them, “Well, if you don't make this appointment, XYZ cannot get done,” it doesn't necessarily change things for them. So something of this sort definitely helps. Now, going to Lauren, I noticed this interesting sentence in the article, "fork in the road," where you describe, based on the current practices and policies, in the direction that we're going in, we can either increase or deepen the divide and disparities or decrease it. Could you tell us a little bit more about what currently exists on the disparity side and how do you see us narrowing that gap in the near future and implementing something that is equitable? Lauren Leiman: What's exciting about this paper is I think as we are talking about trying to condense this discussion down to something that's really digestible for everyone in the community, there are six barriers that we've identified. And I also should start by saying the working group that we have within BloodPAC that wrote this paper is intended to look at two different areas. One is that broadly, liquid biopsy still isn't available for the majority of the population domestically here in the US so that's a problem. In addition, it's clearly not available in underserved areas, and that's an even deeper divide. So we're kind of at this fork in the road because it's not broadly accessible to the majority of patients today. And so we have this moment in time where we're able to make a decision to bring everyone along with us, which is very exciting but also will take a lot of work. And these six barriers that the paper identifies, I think are very clearly articulated. They are: lack of uncertainty around test performance, the lack of familiarity with this technology, inconsistent payer coverage is an issue, mistrust of the medical establishment - especially in underserved areas, fear of discrimination in seeking this kind of technology, and the difficulty with terminology.  I think that the whole liquid biopsy community has a role to play in addressing these six areas. I think that BloodPAC, in particular, as a consortium and a collaborative process for 66 different organizations that work in the field, we have a role to play, most certainly in helping to address specifically some of these areas. We have working groups that specifically address reimbursement and policy, so that would obviously fall into payer coverage of these tests. We have working groups creating lexicons both in the molecular residual disease area, as well as our multi-cancer early detection areas. So creating terminology and lexicons that are consistent across the entire community and also digestible for patients, which is really important. And so mitigating these barriers is going to be a collaborative process across all stakeholders in the liquid biopsy field. And I think BloodPAC is uniquely positioned to address many of these  because of our diverse stakeholders and membership, which is exciting. But I do think that this is the perfect moment in time now to start addressing these challenges, and we shouldn't wait much longer, as we think through how we can bring everyone along with us and make sure we're not leaving anyone behind. Dr. Rafeh Naqash: As this entity or consortium, as you call it BloodPAC, has moved forward, this is a question for both of you, Emma and Lauren. Emma, I guess you can start. How were things five years back? What are some of the things that you have been able to achieve, and where do you potentially see the next five years? Dr. Emma Alme: I think we have made a lot of strides on the coverage side when it comes to advanced cancer testing for liquid biopsy. By no means are we there by any stretch of imagination, but we're starting to see some coverage adoption, which does make a huge difference because at the end of the day, that's so important to ensure equitable access. Especially when we're talking about a technology that has the potential to close some of the barriers in precision medicine because of the fact that you don't need access to some of the medical facilities, as you pointed out earlier, rural patients don't have access to. Because transportation is not necessarily a barrier here the way it is for some for some of these other treatment aspects. But if you don't have consistent pay or coverage, that's a place where you're really going to see drop off in terms of patients not getting equitable care and not getting standard of care as liquid biopsy enters into that realm.  The increase we've seen in private payers adopting coverage, the way we see Medicare coverage for advanced cancer liquid biopsy, is encouraging. We've seen states adopt legislation to require coverage of biomarker testing, that's passed in 15 states now, thanks to the work of the American Cancer Society and a broad coalition of stakeholders. I think that's beginning to make a difference, but we have a long road to go. We still, on the MRD side, that's just emerging. And so one space where we have some recommendations on this is continued evidence generation - continue to gather that clinical utility data that will support payer adoption increasing on the advanced cancer side, but then moving across that cancer care continuum to those other types of liquid biopsy tests. I think that's hugely important and there's a role for BloodPAC to play in that as well, especially in making sure that we bring everyone to the table to have these conversations on what is the evidence that, we need to generate, what should that look like, what are the standards to ensure that everyone feels confident in these tests. That's one area that we're really excited to see.  And I also think another space is on the diversity in clinical trials. It's so important to make sure that when we are bringing these tests to market, the data that we gather to support that is representative of all patients who can benefit. It is so important to make sure that the tests work, but also to build confidence in all of the people who are going to get these tests and feel like, “Okay. I know that this test works for patients that look like me, too.” And so that is something that at Guardant we are working really hard on. We read out our clinical trial, ECLIPSE, for our blood based test screening for colorectal cancer a little over a year ago, and we were really happy to be able to say that our trial was representative of the US population, particularly for Black Americans, where colorectal cancer incidence is increasing, 30% to 40% higher rates of mortality, in Black patients than White patients for CRC. So it's especially important to make sure that the population is representative in the clinical trial of the patients who will benefit.   And I think we are seeing companies increasingly realize their responsibility in that space and it's something that we can all really prioritize moving forward with things like making sure transportation is accessible to patients, making sure that clinical trial materials are accessible, culturally sensitive in a broad set of languages. There are a lot of different activities. You have mentioned mobile phlebotomy earlier, that can be incorporated into trials working with community centers and not just academic medical centers to ensure that the trials are taking place close to where patients live and work. This is a tractable problem and I think we've made a lot of headway in the five years. But looking to the future, there's still a lot more we can do together to ensure that work continues. Dr. Rafeh Naqash: All excellent points. And I completely agree with you. Bringing the trial to the patient is more important and likely to lead to better outcomes than the patient driving six hours to a facility to come on for trial.  So, the question for Lauren that I have from a physician or scientist standpoint, is what gets covered or does not get covered is not necessarily that I know about in my daily clinic of 15-20 patients. What is the difference between different states having different coverage policies for something like this? If it's the same payer in state A and the same payer in state B, why is the coverage policy in state B different from that in state A? And what are some of the things we can do locally and at a national level to help bridge some of these disparities and gaps? Lauren Leiman: I'm going to hand that question over to Emma. This is her bread and butter.  Dr. Emma Alme: That is such a great question, and I wish I had a more satisfactory answer for you. The reality is that when it comes to diagnostics, coverage is really a patchwork, compared to when we think about drugs whether it's FDA approved, we expect to be covered. With diagnostics, it's really up to the insurer. And I keep going back to the advanced cancer space because that's where we see the broadest coverage because it has been around the longest. But we see broad coverage from Medicare for these types of tests. But, for private payers, it's really a patchwork. We see a lot of payers only just starting to cover these tests, maybe where there's a CDX indication with an FDA-approved drug we see it, but not more broadly for tumor profiling. Especially not for the larger, more expensive comprehensive genomic profiling panels that are more expensive. I think you can extrapolate the obvious reasons why that might be. But, as this is being moving into NCCN guidelines, we see very slow adoption by some private payers.  And you touched on the legislation in different states. This coalition on American Cancer Society has been spearheading is trying to pass state-level legislation that will align coverage with a strong, robust set of evidence, and that's an FDA-approved companion diagnostic indication, medicare coverage, whether it's an NCD National Coverage Determination, a Local Coverage Determination, or National Clinical Practice Guidelines like NCCN, so really a robust set of evidence. And so this is resonating with state legislators across the country where we are seeing that take off in 15 states. But the political climate is different in different states so there are differences in terms of which state will adopt this, some of the differences are in language that they put into this. But even now that these are passing, we're seeing differential implementation, some plans are not necessarily reading this legislation and saying, “Okay, I have to cover all the tests that Medicare covers.” They are thinking that maybe they have some agency to put on other medical necessity criteria. So I think there's a lot that will play out on the individual state level to see how this nets out. But it's really kind of how different insurance companies and plans are interpreting these mandates, are interpreting guidelines, etc.  But you touched on the differences between the states and one of the things that has actually been shown in data from the precision medicine coalition is that even when you change insurance coverage for one individual plan, it doesn't necessarily translate into adoption in the direct correlation that you would expect. And part of that is because it's such a patchwork and it's so chaotic. Providers don't necessarily know for their patients which plan will cover, which one won't. They're very hesitant to subject their patients to out of pocket costs and so you get providers being reticent to order liquid biopsy just because of this coverage landscape. And so there really is that need not just to go step by step but get broader coverage for these patients across the board.  And so I think the long term vision is can we get to a change at the federal level. That's hard compared to the state level. It's a long road ahead. That's why I started this with I don't have a satisfactory answer. There is still a lot of chaos ahead even though we made some progress along the way. Dr. Rafeh Naqash: I completely agree. Lots of things to do together. But, in my daily role as a physician or a scientist, I come across situations where a patient's situation was denied for liquid biopsy, then the company went and appealed or insurance doesn't want to pay for it, and then they ask for peer-to-peer review, which is a lot of time and energy on the provider's side, the physician's side, even for as simple as a CAT scan for cancer, let alone a liquid biopsy. I started thinking at that time, is there a scenario where if I were ordering a Guardant or a foundation or any liquid biopsy for that matter, can they not provide additional support where I don't have to do a peer to peer and I can spend time and energy concentrating on the more important patient issues that are right in front of me, rather than having to wait for an insurance company to call me at a certain time of the day where I may or may not be available and then having to reschedule the call and spend another 30 minutes to them explaining. So I don't know if you guys on the other side of the aisle also think about some of these issues, but could that be a scenario that could potentially be implemented in the near future?  Dr. Emma Alme: Yes, absolutely. This is something that we at Guardant think about a lot. One of the challenges is that, as a laboratory offering liquid biopsy, you are an ancillary provider, and so I think you touched on it, a lot of this role falls to you as the physician to secure prior authorization and to be the patient's advocate. And not all plans – this is often true for Medicare Advantage – allow the laboratory to be the one to, for example, initiate prior authorization and provide the medical necessity information to make sure that that test is approved by the insurance company, and then to be the advocate for that patient in appeal process as you mentioned. And I think there is a lot of education that needs to happen among policymakers to make some tweaks to this process to ensure that the patient can have access, that the laboratory can be involved in the process where it makes sense, to smooth out this process.   And exactly right, I think you touched on a place where it is a huge burden for providers. There are places where the laboratory is best equipped to move the patient through that process and there's a lot of red tape that we can help overcome. And that's not specific to liquid biopsy. I think that's true across the diagnostics industry. But you're exactly right that it is another hurdle to access is if this is a process that has a lot of red tape. So I'm pleased to hear you think about this the same way.  Dr. Rafeh Naqash: I'm glad you guys are having those conversations, having conversations is the first important step to make a change in the near future.  If there's a patient listening out there and that patient has gotten a recent bill of $5,000 for liquid biopsy, what are some of the steps that you would like to highlight for them from a patient standpoint so that they can advocate for themselves? And should they talk to the physician in the company? Should they directly approach the company to not have that additional financial toxicity in situations where it may not be covered?   Lauren Leiman: I would 100% encourage those patients to please reach out to the company. I can only speak for Guardant but we have a patient access program. Our team calls any patient that's going to have more than $100 out of pocket because our goal at Guardant is to make sure that patients have access to the testing they need to inform their treatment and get the best possible care. I think we're all aligned across these companies across both- like we want to make sure that we are lowering the burden for cancer patients. There's already so much stress on these patients initiating treatment. They don't need to have the added stress of battling insurance. So we're here to help and no patient should be on their own in that space. So please tell your patients to reach out to the company in those instances, but I would hope that they would already have gotten outreach from the company in the first place. Dr. Rafeh Naqash: I often discuss with some of my colleagues about the financial burden of cancer care, unfortunately, that people tend to have. And I remember this scenario a couple of months back where a patient of mine, when I sat down in the clinic room, they had this big, thick folder with them. And after I finished the discussion about what was going on with the cancer, they said, "Could you help figure this out?" And they opened this folder. It had so many bills, and one of the bills was obviously a liquid biopsy bill. And that was my understanding, too, that there is a lot of resources available to these people. And eventually things worked out. The company took the cost of whatever was not being covered by the insurance. But again, you touched upon an aspect in the article about educating the physicians, the providers. I think definitely a lot of work needs to be done there so that the patients can advocate for themselves and the healthcare providers can advocate for the patients, too, like having those checks and balances and those resources present and in the institutions where these people get cared for or knowing what's the right way to channelize these issues and to whom within the companies, so that all of this gets taken care within a timely period, so that the patient doesn't come back with the same issue six months later, “I still have this bill,” that even if it's being sent to the patient or their family by mistake, it does add a lot of psychological pressure.   So I think a lot of things potentially need to be done in that space, and hopefully you guys are still doing that and continue to do that, make progress in that space to help mitigate and alleviate some of that patient level burden, which is extremely crucial in their care. Lauren Leiman: I think what's interesting about what we're looking at now is BloodPAC is thinking through these financial challenges, the coverage challenges for someone who's probably made it to an academic center to access these tests to begin with. And so to go back a little bit in the conversation, I think there still are challenges, which I'd love to hear more about from the experience of a clinician. But we have talked about, does mobile phlebotomy access everyone? Is it capable of providing access for everyone? I don't know. There's new technologies that we are looking at, like home blood collection. Most of the companies that we work with right now, they're not getting enough quantity. The quantity isn't there. But is that something that we should be pursuing? Because as you've already said, people drive six hours, and sometimes you can't make that drive. And sometimes a mobile phlebotomy lab is not able to get those six hours away. There's a limit on how far they can go. That's a huge challenge.  I'm also fascinated by the idea that if you were to eliminate coverage as an issue, so if we were to say we're offering tests for free, is there still the educational barrier, the understanding barrier that we are not putting enough emphasis on? I don't know the answer to that question. I think there is a large element to that, though. And I think that when you say education, I have asked colleagues, "Okay, guys, who are we educating? Are we educating the clinician on specific tests? Are we educating the community health worker somewhere else outside of an academic center? Are we educating the patients themselves? Do they need to really understand exactly what this kind of futuristic technology is and what it can do for them?" Those are a lot of permutations of what if, what if, what if, what is the barrier? And so to take a step back, the reality is for that big bucket of individuals that I talked about at first, yes, coverage is going to be the primary barrier for them. But if you were to remove that barrier for some individuals, I think you still have a lot of challenges left ahead of you, which is essentially what the paper is saying. But I think that that is the really big question that I still have in my mind. If we can eliminate coverage, what's left and how do we address it? Dr. Rafeh Naqash: To that point, I would like to add also- you pointed out educational barriers and there's definitely educational barriers on the provider side also, physicians, whether it's academic or community, that's a different discussion altogether. And this is not just one example, but this is an example that I'm giving because there's several other examples similar I've seen where somebody gets a liquid biopsy done in the community setting, or maybe even in an academic setting somewhere else. And somebody like me who deals with some of these results, I do a lot of precision medicine, I do a lot of genomics, but that's not everybody's interest or forte. That's not something that everybody's necessarily interested in or I try to read each and every detail in a report and understand implications, and not everybody necessarily thinks that that's the best utilization of their time. And I have identified a lot of patients that have been in the system within our state or outside our state where liquid biopsy two years back showed a certain potential germline mutation with a very high variant allele frequency and never got any germline testing. And then I see the patient and I start connecting the dots and the patient gets germline testing done - patients is positive, children are positive, children get XYZ procedures done as part of surveillance or mitigation strategies to prevent future cancers, which again, prevention is cure. At the end of the day, you catch something earlier, as we all know, higher chances for cure.  So I think that part of education, we still need to do a lot more on educating the providers, the physicians, or making it somewhat easy, like is there a way that, well, if you have a potential finding of a germline mutation, let's say on a report, instead of just mentioning the potential of germline mutations, maybe we can go to the next level and offer free germline testing and free genetic counseling and make sure that you communicate with that provider versus the responsibility being on the provider or the physician that, “Hey, did you read this carefully? Did you miss something? Did you not miss something?” This is something I have come across and we're actually doing a project right now looking at some of that and analyzing the data and the percentage is pretty significant, and hopefully, if and when the results of that project are published, you will understand how much of a difference it actually can make in the lives of patients and their families to catch something early.  Dr. Emma Alme: I think you raise a really good point and your example of germline testing along with tumor profiling is a good example of the kinds of questions that we'll encounter as liquid biopsy moves across that cancer care continuum. So I think we do have to be thinking about what kind of education will we be giving to providers for how they integrate, for example, MRD liquid biopsy testing with standard of care imaging, what does that patient management process look like? On the early cancer screening side, what happens when you get a positive test for a patient? What does that diagnostic workup look like? Especially when there isn't necessarily a standard of care screening pathway- isn't a diagnostic pathway. Whose responsibility is that? There are so many outstanding questions through how we think about provider education across this board that really will take all stakeholders together to really formulate what this looks like.  I think you raise a really good point. Right now, I think we all have more questions than answers, but I think it's an important place for us all to be working really hard on right now, to ensure that this doesn't roll out in a way where there is confusion, especially where the providers offering liquid biopsy, maybe primary care physicians who aren't necessarily, as you said, going to be well versed in the literature on liquid biopsy, thinking about these tests report the way that you are right now. There's a lot of work to be done there. Dr. Rafeh Naqash: Absolutely. It was a pleasure talking to both of you about the science, logistics, and payer aspects. A couple of quick minutes on both of you as individuals. I like to start with you, Lauren, can you tell me briefly, what's your background? How did that background connect to what you're doing today? And what else have you learned in this process? Lauren Leiman: Sure. I am Lauren Leiman. I'm the Executive Director of BlooPAC. My backgrounds are primarily in communications and business and developing collaborations that are mutually beneficial for all participants. I have worked in finance. I've worked in Africa for many years for an economist and really decided during that time that health care and health initiatives were really what interests me and ended up working in a melanoma foundation for many, many years, developing interesting collaborations between academic institutions and funding formats, and took that to the White House for the first White House Cancer Moonshot as the Head of External Partnerships, and work towards identifying collaborations between different government agencies and different companies, as well as straight corporate commitments to the Cancer Moonshot, which was “a decade of progress in half the time”, the mission statement.  And having worked in melanoma for a while and working at the Moonshot, I'd heard about this liquid biopsy technology. It's out there and I thought it was pretty cool. I have melanoma in my family, and was like, wouldn't it be really interesting if you could get your blood drawn and just tell me if I have melanoma as opposed to kind of scanning my body every six months? And my colleague Jerry Lee, at the time kind of dropped a ream of paper on my desk and said, “Read this.” So I'm neither MD nor PhD, I'm a lowly MBA, who went home and read through everything and came back and said, “You don't have a science problem. You have the collaboration problem, you need to work together, you need to share your data and share your information, which was kind of the birthplace I guess for BloodPAC - could we again, aggregate our data, bringing together these experts in the field to help accelerate the development and approval and accessibility of these technologies. That is my background. Again, an interest in things, going back to Africa and the time I spent there, I'm heavily interested in underserved populations, not just domestically but globally. My hope is that eventually BloodPAC starts really engaging in how do we increase access for all to these really exciting new tests? I do receive, BloodPAC and I as the executive director, receive calls probably once a month from different startups around the world saying, “Good luck with all your $500 test. I want a $5 test, how are we going to get there?” Which you know, I think is the absolute goal for everyone. But slowly but surely, I think we are going to work towards increasing access for all not just domestically here and not just underserved populations here in the US, but hopefully locally as well. Dr. Rafeh Naqash: Thank you, Lauren. Same question to you, Emma. Could you tell us about your background and how it led to your current work and some of the things you learned? Dr. Emma Alme: Absolutely, my background began on the science side. I did a PhD in biochemistry at UCSF University of California, San Francisco. About halfway through my PhD, which I think is a realization many have, I discovered that I loved talking about science and thinking about science and reading about science, but it would be okay if I didn't have to pick up a pipette again. At the time, I was so invigorated by all of the research going on around me but realized that, similar to what Lauren said, it wasn't the science that was the barrier in a lot of cases of this research really reaching patients and changing their care. There were so many policy barriers that were standing in the way of that that I felt like I really wanted to help tackle and so I was fortunate in the fact that there are a lot of fellowships out there for PhDs in science to move into policy roles and serve as science advisors, so I did a smattering of those all around DC. I worked at the National Academy of Science. I worked at NIH and then I went to Congress, where I was a Health Policy Fellow for Anna Eshoo and got to interact with so many different companies in the biotech space and learn about all of their amazing technology, including liquid biopsy that folks were working on where there again, were so many barriers to adoption, where there were policy solutions, and I got really excited to work on that. It was the perfect nexus of my background and biochemistry and genetics and health policy.  And so the opportunity came up to work on policy for Guardant who was really thinking about those issues. And so I jumped at the chance to spend all of my time thinking about how do we increase access for patients? How do we make sure that this innovation actually gets into their hands through changes in coverage and reimbursement? And also thinking about most of the things that we've been talking about today - diversity in clinical trials, how we brought in education for patients and providers. So it's been a really exciting space to work in. It's been super fun to get to help the Guardant work with BloodPAC and I think it's an amazing group of collaborators that brings me a little bit back to my academic roots in terms of enjoying the kind of conversations that all these folks have together as we think about standards. That's been a really exciting place for me to sit in the health policy world combining all of that experience together. Dr. Rafeh Naqash: Thank you so much. It looks like all of you within the BloodPAC and perhaps outside the BloodPAC are people driven by a common vision and mission and hopefully will succeed in all of those things that you're trying to achieve. Thank you for giving us the opportunity to talk to you guys and thank you for publishing in JCO Precision Oncology. Hopefully we'll see more of your work with regards to implementation and some of the next steps that you're taking and perhaps even the data for some of these studies that you're combining together, within JCO Precision Oncology in the near future. Dr. Emma Alme: Thank you so much for having us.  Lauren Leiman: Thank you.  Dr. Rafeh Naqash: Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe, so you never miss an episode.  You can find all ASCO shows at asco.org/podcast. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guests' statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Leiman COIs: Stock and Other Ownership Interests:Company: Illumina Company: Eli lillyAlme COIs:Employment: Company: Guardant Health  Stock and Other Ownership Interests: Company: Guardant Health  

Dr. Iyad Alnahhas interviews Dr. Ricardo Soffietti about the recent RANO review entitled "Liquid biopsy for improving diagnosis and monitoring of CNS lymphomas: a RANO review" published online in Neuro-Oncology in March 2024.

Dr. David Shulman is a pediatric oncologist at Dana-Farber Cancer Institute. He studies novel therapies and biomarkers for patients with advanced sarcomas. In addition to early phase clinical trials, Dr. Shulman co-leads an effort to evaluate circulating tumor DNA, a type of "liquid biopsy," as a potential tool to improve the ways in which we treat patients with bone and soft tissue sarcomas. He joins us on OsteoBites to discuss the LEOPARD Study: Liquid Biopsy in Ewing sarcoma and Osteosarcoma as a Prognostic And Response Diagnostic

Description: Dr. Maya Graham interviews Dr. Carl Koschmann about his and his team's recent manuscript entitled: "Liquid biopsy in H3K27M diffuse midline glioma", published online in Neuro-Oncology in December 2023. Download PDF

Prof. Dr. Wolf von der Uniklinik Köln sollte jeder Lungenkrebspatient kennen. Er ist unter anderem der Mitbegründer des nNGM ( Nationale Netzwerk für genomische Medizin) . Wie wichtig dieses Netzwerk und die Molekulare Diagnostik sind erfährst Du in diesem Gespräch, neben vielen anderen Themen, die ich in den Shownotes aufgelistet habe. Ich kannte Prof. Wolf bisher nur als Arzt vom vorletztem Jahr, als ich mir eine Zweitmeinung bei ihm eingeholt habe und war damals schon von seinem Fachwissen -und empathischen Persönlichkeit beeindruckt. Das konnte er in diesem facettenreichen Gespräch noch einmal steigern. Ich habe mich zwar auf dieses Gespräch vorbereitet, aber letztendlich verlief es dann doch anders, weil Prof. Wolf sehr viele Themen schon von sich aus angesprochen hat. Uns beiden hat das Gespräch Spaß gemacht und ich würde mich über Rückmeldungen freuen, ob wir das fortsetzen sollen mit dem Schwerpunkt "Forschung" und "klinische Studien". Kurzbiographie von Prof. Wolf: https://innere1.uk-koeln.de/erkrankungen-therapien/lungenkrebs/ Patientenorganisation zielgenau e.V. https://www.zielgenau.org/diagnostik-und-therapie/patientenorganisation/ Hier die Aufteilung des Gesprächs: 00- 1.40 Vorstellung Prof. Wolf 1.55 – 4.50 Erklärung der molekularen Diagnostik, Treibermutation & Medikamente 05.00 -- 7.26 Entwicklung der genomischen Medizin 7.30 – 10.16 Aufschlüsselung der verschiedenen Lungenkrebskarzinome- Klein – und Nichtkleinzellig 10.20 –  16.30 Stigmatisierung von Lungenkrebs 16.20 – 19.00  Warum ist die molekulare Diagnostik noch nicht so verbreitet? Wie sieht die Realität aus? 19.00 – 22.29 Jeder Körper ist anders , Kommunikation mit dem (aufgeklärten Patienten), Statistik , Ursachenforschung 22.29 -  26.00    Integrative Medizin, Komplementärmedizin, Krebs und Bewegung, Alkohol und Krebs (Kölner Ansicht ), Lebensqualität 26.00  - 27.10 „Rezidivgespür“ von Patienten 27.20 – 31.00   Das dt. Gesundheitssystem und die Lungenkrebsdiagnostik im internationalen Vergleich 31.03 – 32.12  „Leuchtturm“ Patientenorganisation „zielgenau e.V.“, Miteinander zwischen Ärzten und Patienten 32.13 -  36.00 Spezialisierte Krebszentren sind wichtig aber nicht alles, System nNGM. Vision einer besseren Zusammenarbeit 36.01 – 37. 50 Zusammenarbeit mit zielgenau, Webinare , Miteinander 37.51  38.30 Der „gut informierte Patient“ 38.31 –  41.10 Die Zweitmeinung ist wichtig, offener Umgang mit dem Arzt , Aufruf von Prof. Wolf 41.11- 43.00 Meldungen im Internet zu neuen Medikamenten differenziert betrachten 43.01- 44.50 Patienten international in klinische Studien vermitteln, Zweitmeinung in Köln holen 45.20 – 49. 10 Grund für eine Chemotherapie vor den Ergebnissen der molekularen Diagnostik 49.30 – 54.00 Liquid Biopsy 54.00 –  54.44 Verabschiedung & auf ein nächstes Mal --- Send in a voice message: https://podcasters.spotify.com/pod/show/kab4/message

Welcome back Gene-iuses!  Jordan and Cassie kick us off with a fun teaser of what's to come in Season 2 of the Absolute Gene-ius series.   We'll be featuring another great season of interesting guests, all using dPCR to progress their diverse research applications. This includes conversations about reproductive biology, liquid biopsy and transplantation research, CAR-T research, the role of bioinformatics in PCR assay design, micro-RNA analysis, differential gene expression analysis, and of course Cassie's Career Corner, where we get to learn about people behind the science.   This teaser, like every episode of Absolute Gene-ius, has the fun baked in to keep it all light and interesting too.  You might even hear some digital PCR jokes!  Visit the Absolute Gene-ius page to access the entire first season and to learn more about the hosts and the Applied Biosystems QuantStudio Absolute Q Digital PCR System.  

CME credits: 1.00 Valid until: 17-01-2025 Claim your CME credit at https://reachmd.com/programs/cme/testing-for-solid-tumors-tissue-and-liquid-biopsy-approaches-using-ngs-technologies-for-cfdna-and-ctdna-analysis/16555/ HER2-targeted treatments have been extensively researched and approved in breast, gastric, and non-small cell lung cancers. Are these same therapies effective at treating other HER2-positive tumors? Join our faculty as they examine the potential role for HER2-directed antibody-drug conjugates in treating advanced solid tumors and discuss the latest data around the efficacy and safety of these agents.

Join our conversation with Dr. Paul Savage—an ER doctor who pivoted to become the CEO of MD Lifespan. After facing numerous health challenges, Dr. Savage redefined his life. He didn't just change his habits, but also delved deep into treatments like stem cell therapy. He'll share how he went from battling fatigue to leading the charge in longevity medicine.We'll uncover topics like the science behind aging, mindfulness and emotional wellbeing, and innovative treatments like Therapeutic Plasma Exchange—think of TPE as a rejuvenating process similar to giving your car a fresh oil change. Plus, we'll touch on the potential of nanotech and genetics in enhancing our lifespan and why it's vital to stay ahead in these fast-paced fields. But it's not all science and tech. Dr. Savage gives us tips on how we can make better everyday choices, dodge environmental toxins, and truly embrace a healthier lifestyle. From the food on our plates to the thoughts in our minds, it's about making choices that count. EPISODE CHAPTERS (0:00:01) - The Journey to Longevity(0:08:12) - Longevity and the Journey of BodyLogic(0:11:57) - Longevity and Causes of Aging(0:23:53) - Therapeutic Plasma Exchange and Liquid Biopsy(0:34:44) - Liquid Biopsy and TPE in Longevity(0:47:29) - Longevity Medicine(0:53:47) - Food Toxicology and Personal Wellness Implications(0:59:53) - Key Insights for Optimal HealthLinks:https://mdlifespan.com/Join Over 18,000 Leading Medical Professionals and Become a Vibrant Wellness Provider Today!

Can wastewater-based surveillance identify the start of the pediatric RSV season? Find out about this and more in today's PV Roundup podcast.

Good morning from Pharma and Biotech Daily: the podcast that gives you only what's important to hear in the Pharma and Biotech world. Diabetes device companies Dexcom and Abbott are increasing their direct-to-consumer marketing efforts as they compete for a larger share of the growing diabetes market. With insurers now covering continuous glucose monitors for more people, device-makers are adopting strategies commonly used by pharmaceutical companies to promote their products.Agilent Technologies has announced plans to wind down its Resolution Bioscience liquid biopsy unit. The company will discontinue operations at the business it acquired two years ago for $550 million.Tandem Diabetes Care's Chief Commercial Officer, Brian Hansen, is resigning ahead of the company's upcoming rollout of its new insulin pump, called the Mobi Pump.Google Cloud's Amy Waldron discussed the tech giant's ambitions in healthcare and the potential risks associated with generative artificial intelligence (AI) in the industry. Generative AI has the ability to create new content, such as images and text, but there are concerns about the ethical implications and potential biases that may arise.The Washington Post reports on the changing landscape of healthcare delivery, with state laws allowing non-doctors to treat patients. AP News highlights the mental health challenges faced by survivors of the Maui wildfire. The CDC is working to overhaul its lab operations following issues with COVID-19 testing. Medical Device and Diagnostic Industry explores the use of plastic in medical devices and its environmental impact.Gilead Sciences has faced another setback with its cancer drug, as the FDA partially halted leukemia studies of the drug. This drug was the center of Gilead's $5 billion acquisition of biotech company Forty Seven in 2020.Regeneron Pharmaceuticals rebounded by winning FDA approval for a longer-lasting vision loss drug called high-dose Eylea. The drug was cleared less than two months after it was initially rejected by the FDA. Additionally, the agency also approved a separate Regeneron drug for an ultra-rare disease.The FDA expanded the use of a neurocrine drug called Ingrezza to include Huntington's disease patients with a movement disorder known as chorea. This approval is expected to intensify the commercial battle between neurocrine and Teva Pharmaceuticals.Genesis, a California startup focused on AI drug discovery research, raised $200 million in a series B funding round. The total funding for Genesis now exceeds $280 million

Drs Sapna Patel and David Polsky explore biomarker development and the clinical utilization of liquid biopsy in melanoma. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989037). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Genomic Profiling of Circulating Tumor DNA From Cerebrospinal Fluid to Guide Clinical Decision Making for Patients With Primary and Metastatic Brain Tumors https://pubmed.ncbi.nlm.nih.gov/33192972/ Digital Droplet PCR in Hematologic Malignancies: A New Useful Molecular Tool https://pubmed.ncbi.nlm.nih.gov/35741115/ Circulating Tumour DNA in Patients With Advanced Melanoma Treated With Dabrafenib or Dabrafenib Plus Trametinib: A Clinical Validation Study https://pubmed.ncbi.nlm.nih.gov/33587894/ Association of Circulating Tumor DNA Kinetics With Disease Recurrence in Patients With Stage IIIB/C/IV Melanoma Treated With Adjuvant Immunotherapy in CheckMate 238 https://meetings.asco.org/abstracts-presentations/220160 Clinical and Molecular Response to Tebentafusp in Previously Treated Patients With Metastatic Uveal Melanoma: A Phase 2 Trial https://pubmed.ncbi.nlm.nih.gov/36229663/ TERT Expression Induces Resistance to BRAF and MEK Inhibitors in BRAF-mutated Melanoma In Vitro https://pubmed.ncbi.nlm.nih.gov/37296851/ Adjuvant Nivolumab Versus Ipilimumab in Resected Stage III/IV Melanoma: 5-year Efficacy and Biomarker Results From CheckMate 238 https://pubmed.ncbi.nlm.nih.gov/37058595/ Adjuvant Therapy of Nivolumab Combined With Ipilimumab Versus Nivolumab Alone in Patients With Resected Stage IIIB-D or Stage IV Melanoma (CheckMate 915) https://pubmed.ncbi.nlm.nih.gov/36162037/ Adjuvant Atezolizumab Versus Observation in Muscle-invasive Urothelial Carcinoma (IMvigor010): A Multicentre, Open-label, Randomised, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/33721560/ ctDNA Guiding Adjuvant Immunotherapy in Urothelial Carcinoma https://pubmed.ncbi.nlm.nih.gov/34135506/ Distant Metastasis-free Survival Results From the Randomized, Phase 2 mRNA-4157-P201/KEYNOTE-942 Trial https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.17_suppl.LBA9503 Melanoma Recurrence Patterns and Management After Adjuvant Targeted Therapy: A Multicentre Analysis https://pubmed.ncbi.nlm.nih.gov/33087895/ From Validity to Clinical Utility: The Influence of Circulating Tumor DNA on Melanoma Patient Management in a Real-world Setting https://pubmed.ncbi.nlm.nih.gov/30113761/ Five-year Analysis of Adjuvant Dabrafenib Plus Trametinib in Stage III Melanoma https://pubmed.ncbi.nlm.nih.gov/32877599/

In this episode, we dive into the potential of liquid biopsies as a method to detect deadly diseases. We speak with three experts – Marta Herreros, Rik Bryan, and Doug Ward – to learn more about the non-invasive nature of liquid biopsies and the process of detecting biomarkers within a patient sample. Rik and Doug discuss their GALEAS Bladder test, which can identify key mutations present in 96% of bladder cancer patients. Tune in to learn more about the potential of liquid biopsies and the importance of early detection! Show notes GALEAS Bladder test – Galeas Bladder BBC and hybrid working – Internal Communications Summit Identification by ears – Ear identification: A multi-ethnic study sample - ScienceDirect Keywords: bladder cancer, patient, liquid biopsy, urine, cells, bladder, urine test, urine sample, mutations, tumor, DNA, cancer, clinical trials, sequencing, samples, biomarkers.

In this episode of Lung Cancer Considered, host Dr. Stephen Liu leads a discussion with two global experts about the current and future roles of liquid biopsy and its use for the treatment of lung cancer.

Dr. Andi Flory, author of "Clinical experience with next-generation sequencing–based liquid biopsy testing for cancer detection in dogs: a review of 1,500 consecutive clinical cases in: Journal of the American Veterinary Medical Association - Ahead of print (avma.org)," discusses liquid biopsy for cancer detection in dogs. Hosted by Associate Editor Dr. Sarah Wright and Editor-in-Chief Dr. Lisa Fortier.INTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA OR AJVR?JAVMA: https://avma.org/JAVMAAuthorsAJVR: https://avma.org/AJVRAuthorsFOLLOW US:JAVMA:Facebook: Journal of the American Veterinary Medical Association - JAVMA | FacebookInstagram: JAVMA (@avma_javma) • Instagram photos and videosTwitter: JAVMA (@AVMAJAVMA) / Twitter AJVR: Facebook: American Journal of Veterinary Research - AJVR | FacebookInstagram: AJVR (@ajvroa) • Instagram photos and videosTwitter: AJVR (@AJVROA) / TwitterJAVMA and AJVR LinkedIn: https://linkedin.com/company/avma-journals#VeterinaryVertexPodcast #JAVMA #AJVRINTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA ® OR AJVR ® ? JAVMA ® : https://avma.org/JAVMAAuthors AJVR ® : https://avma.org/AJVRAuthorsFOLLOW US:JAVMA ® : Facebook: Journal of the American Veterinary Medical Association - JAVMA | Facebook Instagram: JAVMA (@avma_javma) • Instagram photos and videos Twitter: JAVMA (@AVMAJAVMA) / Twitter AJVR ® : Facebook: American Journal of Veterinary Research - AJVR | Facebook Instagram: AJVR (@ajvroa) • Instagram photos and videos Twitter: AJVR (@AJVROA) / Twitter JAVMA ® and AJVR ® LinkedIn: https://linkedin.com/company/avma-journals

Dr Raez discusses findings from a study of patients with newly diagnosed non–small cell lung cancer who received both liquid and tissue biopsy, the benefits of liquid biopsy's relatively short turnaround time, and financial barriers to conducting multiple next-generation sequencing tests per patient.

(00:31) Could you each provide us a little bit about yourself and your background? Dr. Zheng, we'll start with you.(01:40) Dr. Mansfield, how about you?(02:07)  Could you explain a little bit about the new biopsy test and the technology?(03:58) Which patients should have this testing and when should it be used?(06:44) What alternative test options are available and how would they compare to the Mayo complete cell-free DNA panel?(08:28) Can you go into a little more detail from a clinical practice perspective about how these tests are used?(10:16) Dr. Zheng, is there anything else you would like to add to this discussion?(10:53) Dr. Mansfield, is there anything else you would like to add to this discussion?

Woman-led Mammogen Inc. is looking for breast cancers in a whole new way:  using liquid biopsy to detect cancers far earlier, for more women, and with greater accuracy than traditional mammograms.  They're also passionate about building a community to support women well beyond their initial diagnosis.  A special look at the promising future for earlier breast cancer detection, in recognition of  Breast Cancer Awareness Month!Find Mammogen Inc. online:  https://www.mammogen.bio/Find IV Bio Holdings online:  https://www.ivbh.studio/Marty Keiser on LinkedInhttps://www.linkedin.com/in/marty-keiser-29181b4/Liz Cormier-May on LinkedInhttps://www.linkedin.com/in/elizabeth-cormier-may-b02a2272/We Get Real AF Podcast Credits:Producers & Hosts: Vanessa Alava & Sue RobinsonVanessa AlavaLinkedIn Instagram TwitterSue RobinsonLinkedIn Instagram  Audio Producer/Editor: Sam Mclean  Instagram    WebsiteTechnical Director: Mitchell MachadoLinkedIn   Reset GamingAudio Music Track Title: Beatles UniteArtist: Rachel K. CollierYouTube Channel Instagram WebsiteIntro Voice-Over Artist: Veronica HortaLinkedInCover Artwork Photo Credit: Alice Moore Unsplash We Get Real AF Podcast OnlineInstagramTwitterFacebookLinkedInWebsiteThe We Get Real AF Podcast is a production of MicDrop Creative, telling stories that uplift, inspire and empower women worldwide.  www.micdropcreative.comSupport the show

What is my biomarker? A newly diagnosed lung cancer patient should ask this question before starting treatment. Why? Because the answer to this question can change the odds and the choices for your personalized treatment plan, especially for Black or African American patients. Black and African Americans must ask their doctors, “What is my biomarker?” to ensure they receive the latest targeted therapy treatment that is applicable. Hear from Dr. Sydney Barned and Brandi Bryant in this episode as they discuss their care and what a difference it made in knowing their biomarkers. And maybe even more importantly, they are advocating that every black or African American should ask that question, “What is my biomarker?”  There are more options for treating lung cancer and they want to make sure every black or African American patient, like everybody, else gains access to that full range of options. Why do Biomarkers matter in lung cancer treatment? Minority and underserved communities must advocate for themselves to get the best treatments, especially treatment that can increase the quality of their lives. Guest Dr. Osarogiagbon dives into not only the importance of asking, “what is my biomarker?”, but why it is essential that Black and African Americans make this question a priority. Thanks to lung cancer research, he's really excited that lots of biomarkers have been discovered to help doctors split what used to be a single disease, into a disease of many different bits and of different sizes.  Understanding biomarkers now allows doctors to predict how the cancer is going to behave. And then determine what treatment is most likely to benefit the patient, in terms of surviving lung cancer - and the quality of life, in response to cancer treatment.  “So, you go from 4% to 6% five-year survival, to up to 60%, if you get the right treatment for right cancer. As with ALK mutated lung cancer, so with some of the other subsets, the EGFR mutated lung cancers, the ROS1 mutated lung cancers, the BRAFF mutated lung cancers, the MET exon 14 mutated lung cancer, all... There are at least nine subsets of biomarker-driven lung cancers, and that continues to change all the time. So, that's why it's vital that we get tested, so we know which treatment would benefit us.” - Dr. Raymond Osarogiagbon Guests: Dr. Sydney Barned, a hospitalist at Ann Arundel Medical Center in Annapolis, Maryland, a lung cancer patient, and a member of the LCFA Speakers Bureau Brandi Bryant, a lung cancer patient, and a member of the LCFA Speakers Bureau Dr. Raymond Osarogiagbon, Chief Scientist for Baptist Memorial Health Care, Director of Baptist Cancer Center's Multidisciplinary Thoracic Oncology Program and Thoracic Oncology Research Group, and Principal Investigator of Baptist's Mid-South Minority-Underserved Consortium initiative, NCORP, in Memphis, Tennessee Show Notes | Transcript | Watch the video Resources: What Do I Need to Know About Biomarker Testing? National Comprehensive Cancer Network (NCCN) Guidelines for Non-Small Cell Lung Cancer What is a Liquid Biopsy for Lung Cancer? 7 Signs of Lung Cancer You Should Know

Dr. Andi Flory, an accomplished veterinary medical oncologist, joins Dr. Andy Roark to discuss the OncoK9 multi-cancer early detection test, a “liquid biopsy” capable of detecting 30 different types of canine cancer. She explains why this test is so different from traditional aspirate and biopsy approaches, what scenarios it might be used in, and how its utilization may increase longevity and quality of life for some cancer patients. She reviews the CANDiD Study and discusses sensitivity and specificity of the OncoK9 "liquid biopsy" test across various types of canine cancers. LINKS: - PetDx: https://petdx.com/ - The CANDiD Study: https://assets.petdx.com/m/611713b73a939868/original/The-CANDiD-Study-Summary.pdf/?utm_source=PetDx.com&utm_campaign=OncoK9&utm_content=CANDiD&utm_medium=Link Clinical validation of a next-generation sequencing-based multi-cancer early detection “liquid biopsy” blood test in over 1,000 dogs using an independent testing set: The CANcer Detection in Dogs (CANDiD) study - OncoK9 Cancer SAFE Tool: https://cancersafe.petdx.com/?utm_source=PetDx.com&utm_campaign=Cancer-SAFE&utm_medium=Link The OncoK9 Cancer SAFE™ (Screening Age For Early detection) tool uses data from over 3,000 cancer-diagnosed dogs to determine the age at which it may be appropriate to start annual cancer screening for your dog. - Resources page: https://petdx.com/resources/ Browse supporting resources, including our clinical validation study, continuing education (CE) programs, research publications and posters, and product documentation. ABOUT OUR GUEST: Dr. Andi Flory, DVM, DACVIM (Oncology) Chief Medical Officer, PetDX Dr. Flory is a specialist in medical oncology with nearly two decades of experience practicing and publishing in the areas of early cancer diagnosis, treatments, trials, and novel diagnostic test evaluation. A diplomate of the American College of Veterinary Internal Medicine in oncology, Dr. Flory graduated from the Ohio State University of College of Veterinary Medicine and completed additional training at Florida Veterinary Specialists and Cancer Treatment Center in Tampa, Florida, and Cornell University. In 2019, she treated a small dog named Poppy for pancreatic cancer. Poppy lost her battle with the disease, but left an indelible mark on Dr. Flory, leading her to a newfound passion for cancer genomics. Soon after, Dr. Grosu tapped Dr. Flory to launch PetDx and serve as its first chief medical officer. Prior to PetDx, most recently she co-directed the oncology internship and served as a medical oncologist at Veterinary Specialty Hospital in San Diego. Dr. Flory founded the medical oncology service at a sister hospital, Veterinary Specialty Hospital - North County. Prior to that she was a staff oncologist, resident advisor and co-chief of the oncology department at The Animal Medical Center in New York City. She has served as a principal investigator for national and international multi-site clinical investigational studies. Dr. Flory is constantly expanding her knowledge in cutting-edge areas of veterinary medicine. She holds a certificate in genomics from The Johns Hopkins University along with certificates in cancer genomics and precision oncology, and genetic testing and sequencing technologies from Harvard Medical School. In addition, Dr. Flory is a skilled lecturer. An avid snowboarder and passionate foodie, when not keeping up with two preschoolers, Dr. Flory loves to travel, spend time with her husband, sons, their cat Mochi, and dog Cheyenne.

When cancer spreads from its original location to other parts of the body, it has metastasized. Central nervous system metastases occur when cancer cells spread from their original site to the brain and spinal cord. Any cancer can spread to the central nervous system, but the types most likely to cause such metastases are lung, breast, colon and kidney cancers, and melanoma.Treatment for brain and spinal cord metastases can help ease symptoms, slow tumor growth and extend life. To determine which treatment might work best for a person's tumor type, some health care professionals now use liquid biopsies. When a metastatic tumor is in a place in the body that cannot be reached through surgery for a tissue biopsy, liquid biopsies are especially helpful.A liquid biopsy involves collecting fluid and analyzing it for tumor biomarkers that can help health care professionals determine the tumor's molecular structure and individualize treatment for the best outcome. "So we have excellent drugs for different cancer types that are really based off of your specific cancer," explains Dr. Wendy Sherman, a Mayo Clinic neurologist. "So, not just your lung cancer, but does your lung cancer have a specific mutation? And there are drugs that match up to the mutation that have been very effective."Dr. Sherman explains that halfof the time when a cancer travels to a different part of the body, particularly to the brain, the cancer may change and lose its mutation. "So, if you treat someone based off of the information that you had a couple years ago from where the cancer started, that may not reflect the current state of your cancer and what it looks like," says Dr. Sherman. And, so, our treatment really depends on that. And with a lot of these new-generation treatments that are going after these mutations, it has been very beneficial to look for those in the spinal fluid. And it absolutely has improved how people deal with this from a symptom standpoint because we're often able to give them often drugs that are better tolerated because they're more targeted."Research is underway to further expand the use of liquid biopsies."We want to learn more about the use of liquid biopsy, particularly as it pertains to spinal fluid for not just brain metastases but also for cancers that start in the brain," explains Dr. Sherman. "And then also, can we use other fluids in the body? Those samples — urine and blood — are being collected and tested so that hopefully we can make progress toward that use."On this Mayo Clinic Q&A podcast, Dr. Sherman discusses the use of liquid biopsy in caring for people with breast, lung and gastric cancer that has spread to the brain and spinal cord.

07/14/2022 | CT & Liquid Biopsy

Caris Precision Oncology Alliance™ Chairman, Dr. Chadi Nabhan, sits down with Dr. David Spetzler, President and Chief Scientific Officer at Caris Life Sciences®, to discuss the latest advances in liquid biopsies, the clinical utility of these offerings, and how precision oncology is leveraging this new source of molecular information to improve patient outcomes. For more information, please visit: www.CarisLifeSciences.com