Oncology care is undergoing a transformation many refer to as the precision medicine era. The premise of precision medicine is to provide the right treatment to the right patient at the right time. An emerging precision medicine technology called liquid biopsy holds the promise of improving outcomes for patients with cancer.
The term “liquid biopsy” refers to non-invasive approaches that allow analysis and characterization of cancers through blood or other fluids, such as urine, without an invasive biopsy procedure. This has become possible because of biological advances revealing that tumors shed cells and other molecules into our bloodstream and bodily fluids, along with technical advances (molecular biology and genomics tools) that enable their detection.
Liquid biopsies are beginning to reduce the need for invasive procedures that are used to obtain tumor tissue for traditional biopsies and biomarker data. They have been approved by the FDA as companion diagnostic tests, where they are used to indicate specific treatments for several cancers including ovarian cancer, non-small cell lung cancer, prostate cancer, and breast cancer. Over time, liquid biopsies will be routinely used to help monitor and fine tune treatments and to provide regular screening for individuals at high risk of cancer.
Cancer diagnostics during COVID
Tragically, the COVID pandemic interrupted cancer treatments for many patients. While tissue-based cancer diagnostics decreased during the shutdown, innovative companies embraced mobile phlebotomy so that diagnostics could be brought to the home. As a result, cancer patients were able to receive the right therapy and care they needed due to the availability of liquid biopsy and other testing outside of healthcare facilities.
However, with promise comes the risk that advances will not be available to vulnerable populations, and health disparities will increase. On the other hand, with the appropriate private-public partnerships and planning, liquid biopsies have great potential to reduce these access disparities. While liquid biopsies are already having an impact on treatment decisions, the field of liquid biopsy is young, and there is an opportunity to ensure equal access and to build trust across all at-risk communities.
Addressing equitable access
BloodPAC is a public-private consortium supporting the liquid biopsy community that develops standards and best practices, operates a data commons so that data sharing can be used to accelerate liquid biopsy research, and engages all stakeholders to increase accessibility and availability. With more than fifty members across public, private, and governmental sectors, the not-for-profit BloodPAC Consortium is uniquely positioned to bring the liquid biopsy community together to address equitable access.
Over the past year, BloodPAC has focused on three main initiatives to address this important challenge.
National and global accessibility
BloodPAC has established an Accessibility Working Group committed to identifying and addressing key barriers to global access for liquid biopsies, with the goal of minimizing disparities and democratizing their availability.
Affordability and acceptance
BloodPAC has established a Reimbursement Working Group to identify gaps in the current U.S. regulations and reimbursement guidelines. The group is developing standardized evidence-based approaches for the wider acceptance and use of liquid biopsies.
Finally, BloodPAC has established an Early Detection Working Group addressing specific challenges and opportunities around utilizing blood-based tools for earlier detection of cancer. The group is not only focused on the technologies themselves, but also on how they can be deployed into underserved communities, which often bear a heavier burden of late-stage cancers.
This is an unprecedented time in the history of healthcare and cancer care in the United States, and we have a unique chance to capitalize on the variety of disruptions and advances currently underway.