Liquid biopsy may provide easier, earlier liver cancer detection

Hepatocellular carcinoma is the most common type of primary liver cancer in adults and among the leading causes of cancer mortality in the world.
By Amy Wallace  |  Oct. 9, 2017 at 2:05 PM
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Oct. 9 (UPI) -- A study by the University of California San Diego has found that liquid biopsy may be a faster and better way to detect liver cancer.

Researchers at the UC San Diego School of Medicine, Moores Cancer Center and Sun Yet-sun University Cancer Center developed a new diagnostic test for early detection of hepatocellular carcinoma, or HCC, using a liquid biopsy containing circulating tumor DNA.

Liquid biopsies work by detecting circulating tumor DNA, or ctDNA, which are fragments of genetic material tumor cells discarded into blood, and offer several potential advantages over other methods of cancer detection. The biopsies are minimally invasive and can be done anytime during therapy, allowing doctors to monitor changes in tumors in real time.

Liquid biopsies can also detect tumors not apparent or indeterminant based on imaging and ctDNA shows the entire molecular picture of a patient's cancer. Tumor biopsies are limited to just the tested portion of the tumor.

HCC is the most common form of primary liver cancer in adults and is one of the leading causes of cancer mortality in the world. There are more than 780,000 new cases and 740,000 deaths each year from HCC, with 40,000 new cases diagnosed each year in the United States and 29,000 deaths.

"HCC and its precursor, nonalcoholic steatohepatitis, have increased markedly during the past decade and disproportionally affect Hispanic males," Dr. Scott Lippman, director of Moores Cancer Center, said in a press release. "California has one of the highest rates of liver cancer in the U.S. This novel report has major implications locally and globally on this devastating disease. It's also the first report to support the potential of ctDNA for early detection for any cancer."

Current detection methods for HCC rely on imaging and a blood test for a non-specific tumor maker alpha-fetoprotein, or AFP, which is elevated when cancer is advanced.

"Non-invasive blood tests or liquid biopsies present a better alternative," said Dr. Kang Zhang, founding director of the Institute for Genomic Medicine and co-director of biomaterials and tissue engineering at the Institute of Engineering in Medicine, both at UC San Diego. "However, there has been little success in developing effective blood-based methods for screening HCC. The only blood test, AFP, has limited clinical utility due to low sensitivity."

The study identified a specific panel of methylation markers that correlated to HCC. The researchers then used a variety of machine learning and statistical methods to analyze their efficacy at detecting and assessing HCC in 1,098 HCC patients and 835 normal controls.

"Our results were very encouraging," Zhang said. "In a large clinical cohort, our blood-based HCC diagnosis highly correlated with tumor burden, treatment response and stage of cancer. Right now, oncologists are quite limited in how they detect HCC and evaluate treatment. Our study is a great demonstration of proof-of-concept for a new, more effective approach that applies to solid malignancies, HCC and beyond."

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