Monitoring Treatment With Different Types of Biopsies in Lung Cancer

Monitoring cancer treatment and detecting resistance is crucial for the effective care of patients with non-small cell lung cancer, an expert said.

There are two ways to assess for potential treatment resistance: liquid biopsy and tissue biopsy. In particular, liquid biopsy, a less invasive approach, involves analyzing DNA fragments in blood to identify potential resistance mechanisms. On the other hand, tissue biopsy, a more invasive approach, provides a deeper understanding of tumor biology.

At the 2024 ESMO Congress, CURE® spoke with Benjamin Besse, medical oncologist and director of Clinical Research at Gustave Roussy in Villejuif, France, to learn more about the benefits of each approach and how they can be used in the care of patients with non-small cell lung cancer.

Transcript:

There are many ways to monitor treatment resistance. Either you can do the liquid biopsy. It's very simple because you can repeat these tests a lot of time, and you capture in the blood small fragment of the DNA of the tumor. Then you can analyze the gene and understand if new mutations, for example, appear and explain the resistance to the treatment.

The other option is more invasive, is to repeat the biopsy on the solid tumor. It's maybe a bit painful, maybe some complications, but you [have] much more information. Obviously, you can extract the DNA of the cells, but you can look also at the expression of proteins and other markers.

So the more convenient one is probably liquid biopsy, but with a bit less, let's say, deep learning on the resistance mechanism.

My feeling is that today, it should be restricted to the research area. In the context of care, it's mandatory when you have a diagnosis of non-small cell lung cancer to have a molecular profile to be sure that you don't find targets for which we have targeted therapies.

But during treatment evolution, you always learn in medicine that if you order a test for patients, it means that this test will impact the way you treat patients after that. And so far, we don't have a test that allows us to sequence and select the next treatment, but it's mandatory to go on with this effort on research.

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