Neurosurgeon Chetan Bettegowda discusses the potential for liquid biopsy to offer valuable guidance for physicians treating patients with brain cancer. This noninvasive approach to assessing a patient’s current cancer progression is close to clinical integration and could impact clinical decision making in the future.
Hello everyone. My name is. I'm a professor of neurosurgery at the Johns Hopkins University School of Medicine and today I'd like to speak about. One of the topics that I was fortunate enough to be invited to speak at the annual neurological association meeting in Chicago in October of 2022. And the topic relates to was commonly being coined liquid biopsy. That is our ability to understand what's happening in the tumor without actually performing a tissue or surgical biopsy. The goal of these liquid biopsies are to understand at the molecular level changes that are happening to the tumor and the neuropsychology realm. This is extraordinarily important as obtaining tissue, tends to be very invasive, requiring neurosurgical intervention and has associated inherent risks. So our ability to interrogate what's happening the tumor by sampling bio fluids, mainly blood and plasma or cerebral spinal fluid are very very important avenues that have been studied extensively by our group and others around the country and globe. Thanks to these extraordinary efforts, we feel these liquid biopsy approaches are very, very close to clinical translation and require a few additional studies that hopefully are perspectively being conducted as we speak that will provide the data and rationale to integrate these technologies into our clinical decision making the crux of these technologies involves identifying material shed by tumor cells into these bio fluids, whether that be the bloodstream or CSF. These molecules can be anything from D. N. A. R. N. A. X. Zones proteins but they're all thought to be tumor specific. Many of the technologies that our group and others have been working on are very intimately related to the D. N. A. Alterations that initiate and drive tumor progression I. E. The somatic mutations that cause brain cancer to arise. And so through the work of many these technologies are now reaching the sensitivity that they may be able to make an important impact on clinical decision making. So the goals of these technologies would be one day to hopefully aid clinicians in their decisions with patients. What sorts of decisions might this technology enable person comes in with an abnormal M. R. I. Unclear whether it's a neo plastic condition, a tumor process or inflammatory or autoimmune. A blood sample or CSF sample might be tested to identify which of those possibilities it might be and then help direct next steps. Other examples include individual who has a known diagnosis of a brain cancer or systemic cancer. We want to understand what's happening in the brain. Are the tumor's responding? Is it coming back? Is their resistance to the treatment that's being offered? Are we able to understand the molecular phenotype of the cancer as it undergoes treatment as we know this is not a static process. So all of these sorts of questions were very hopeful. Can be enabled with these liquid biopsy technologies. Were very very optimistic that with the continued ongoing prospective studies that the variety of technologies currently in the space can be further interrogated and that the best ones can be brought to clinical translation. Very hopeful that this can make a major impact in the way we take care of our patients who have brain cancers, help them have the best possible outcomes. Thank you very much for taking the time to hear my talk today and very much appreciate the opportunity.