A prevailing truth in medicine has always been that the earlier the intervention, the better the outcome, and with colorectal cancer, this truth is a stark one — early and late stage diagnoses have drastically different trajectories. When caught early, many cancer patients are able to get to a point that doctors refer to as the “no evidence of disease” stage (NED). That’s good news. But this is still only the beginning of many patients’ cancer journey.

“Many patients get to this point where they’ve dealt with their primary cancer,” says Lawrence LaPointe, Ph.D., an expert in screening technology and CEO of Clinical Genomics. “But, in that population, approximately 30 percent of them will recur. That’s where colorectal cancer becomes truly deadly.”

A new kind of test

“We need to focus on the large number of survivors that we have,” says Nancy Baxter, M.D., Ph.D., spokesperson for the American Society of Clinical Oncology. “There are things that can be done when recurrences are detected early that couldn’t be done at a later stage.”

When colorectal cancer relapse occurs, it is usually metastatic, returning in different parts of the body such as the liver or lungs. Not only can these recurrences be more dangerous, they can also be harder to detect, and for a long time the tools used for monitoring recurrent disease have fallen short. The standard method has been to test for classic cancer markers — e.g., embryonic proteins — that may indicate the presence of cancer.

However, this test, called carcinoembryonic antigen (CEA), only detects the recurrent disease about half the time, and, in some patients with different biochemistry, can be ineffective. Chances for false positives are also high.

Noticing this gap in monitoring technology, LaPointe and his team have developed COLVERA™, a new liquid biopsy test to monitor colorectal cancer recurrence by detecting tumor DNA circulating in a patient’s blood stream (referred to in the medical community as “ctDNA”).

“ctDNA is a precise marker,” says LaPointe. “It’s a specific, actionable piece of data. Doctors don’t need to wait and wonder what it really means.”

“There are things that can be done when recurrences are detected early that couldn’t be done at a later stage.”

Liquid biopsy, here and now

COLVERA has already launched among colorectal cancer patients who are NED and are now in the follow-up care stage and undergoing regular surveillance testing to detect potential recurrence. In a head-to-head clinical study, COLVERA has been demonstrated to detect two times more recurrences than CEA. Liquid biopsy has been talked about as technology of the future, but it’s here right now and already saving lives.

With these encouraging results, LaPointe is excited for what this technology means for the health care industry. He and his team are already planning further trials to explore the possibilities of liquid biopsy.

“We’re going to be very aggressive in gathering clinical evidence, across the spectrum, using COLVERA, because tests for ctDNA are a rapidly evolving area in clinical diagnostics,” says LaPointe, whose company is currently partnering with the National Cancer Institute to carry out a nationwide study. According to him, the future of ctDNA testing is bright.

“[Liquid biopsy tests] target actual genetic elements of the disease, and, by detecting that in circulation, they’re non-invasive, convenient, relatively low-cost and accurate. I think this area is going to see a lot of growth over the next 10 years.”

Speculation aside, this technology is making a real difference for colorectal cancer patients right now, improving outcomes by finding more recurrent cancers in the early stage.