Local study demonstrates synergies of using blood-based liquid biopsies to complement tissue biopsies for lung cancer diagnosis
A*STAR, Changi General Hospital and Lucence, collaborated to conduct the first local prospective study which demonstrated that a blood-based liquid biopsy can be used to complement the conventional tissue biopsy for lung cancer diagnosis
image: Lung cancer cells from liquid biopsy under a microscope (Image Credit: A*STAR’s IBB) view more
Credit: Dr Jamie Mong, Senior Scientist, Institute of Bioengineering and Bioimaging, A*STAR
SINGAPORE – Researchers from A*STAR’s Institute of Bioengineering and Bioimaging (IBB), in collaboration with Changi General Hospital (CGH) and Lucence, a local biomedical start-up, conducted the first local prospective study which demonstrated that a blood-based liquid biopsy can be used to complement the conventional tissue biopsy for lung cancer diagnosis.
The study focuses on non-small cell lung cancer (NSCLC) and has shown that a liquid biopsy test could be used to extract relevant information for a preliminary diagnosis. This would benefit some patients who have had their cancer diagnosed, allowing them to track their response to treatment, or learn whether cancer has returned, and better assess and select the most suitable treatment earlier, using evidence-based methods.
NSCLC accounts for 85 per cent of all lung cancers, making it one of the most common causes of cancer death worldwide[1]. The median age of NSCLC diagnosis is 70 years of age and approximately 40 per cent of patients are diagnosed at a late stage. Such patients would benefit from the added option of liquid biopsies, which can provide additional information about the cancer that would complement tissue testing.
Tissue biopsies are a vital part of cancer care as they provide representative tissue of the actual tumour that can be assessed by pathologists in a highly accurate manner, and are used to confirm a cancer diagnosis, identify the cell type of the tumour and provide predictive biomarkers of response to targeted treatments. While tissue biopsies remain the gold standard for cancer diagnosis, liquid biopsies, which are performed on blood samples, are able to complement this process and provide early detection of cancer recurrence.
The liquid biopsy works by detecting mutant DNA from mutated cancer cells, which cannot be found in normal DNA. While the type of cancer cannot be confirmed, the information from the liquid biopsy helps to detect cancer, determine the appropriate course of treatment and potentially improve time to report and time to treatment. In this study, the process from blood-based liquid biopsy to diagnosis took an average of 10 days. Turnaround time for tissue results may take longer, depending on the quantity and quality of the specimen being biopsied.
Working with a local biomedical start-up, Lucence, the team tapped on IBB’s capabilities in ultrasensitive diagnostic assays and technologies and Lucence’s liquid biopsy test to process the samples in a clinically accredited laboratory. IBB researchers validated the results in tumour samples and clinical data provided by CGH. The results are applicable for local hospitals and clinics. It would also be clinically impactful for local patients.
Dr Jamie Mong, Senior Scientist at A*STAR’s IBB, said, “The aim of IBB’s research is to design and develop studies to help improve diagnostics tools for patients. The findings from this collaboration with Changi General Hospital and Lucence have shown that blood-based biopsies are very useful in preliminary diagnosis of non-small cell lung cancer, and this could help to improve health outcomes for patients.”
“The research study findings showed the feasibility of liquid biopsy as an additional diagnostic option for non-small cell lung cancer when tissue biopsy for lung cancer mutation testing is not viable, particularly for medically unfit patients with progression of the cancer disease. In innovating healthcare for tomorrow, CGH collaborates widely with research partners to create new value and enhance care for patients,” said Clinical Associate Professor Augustine Tee, Deputy Chairman, Medical Board (Medical Disciplines) and Senior Consultant, Respiratory and Critical Care Medicine, Changi General Hospital.
“This collaborative study shows that liquid biopsy yields additional 26.8% actionable treatment options for patients, because of the limitations of conventional tissue testing,” said Dr Min-Han Tan, Founding CEO and Medical Director at Lucence. “Together with a ten day turnaround time, this means earlier and more guideline-concordant cancer treatments.”
Beyond diagnosis, the blood tests can be also used to monitor a patient’s condition and how receptive they are to treatment.
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About the Institute of Bioengineering and Bioimaging
The Institute of Bioengineering and Bioimaging (IBB) is a multi-disciplinary research institute under A*STAR that spearheads translational research at the interface of biology, chemistry, physics, engineering, and medicine. IBB’s mission is to develop new technologies and engineering solutions to address health, medical and sustainability challenges. IBB’s research activities are focused on Bioengineering Systems, Biophotonics & Bioimaging, and Biomedical Devices & Diagnostics. The Institute has published numerous papers in leading scientific journals and has filed many patents for its inventions. IBB’s technologies have been commercialised through the establishment of more than 10 spin-off companies. For more information on IBB, please visit www.a-star.edu.sg/ibb.
About the Agency for Science, Technology and Research (A*STAR)
The Agency for Science, Technology and Research (A*STAR) is Singapore's lead public sector R&D agency. Through open innovation, we collaborate with our partners in both the public and private sectors to benefit the economy and society. As a Science and Technology Organisation, A*STAR bridges the gap between academia and industry. Our research creates economic growth and jobs for Singapore, and enhances lives by improving societal outcomes in healthcare, urban living, and sustainability. A*STAR plays a key role in nurturing scientific talent and leaders for the wider research community and industry. A*STAR’s R&D activities span biomedical sciences to physical sciences and engineering, with research entities primarily located in Biopolis and Fusionopolis. For ongoing news, visit www.a-star.edu.sg.
About Changi General Hospital (CGH)
Changi General Hospital (CGH) is an academic medical institution caring for more than 1 million people in Singapore. A tertiary referral centre with over 1,000 beds, CGH is committed to medical research and education, clinical innovation and care for patients through a comprehensive range of medical specialties and services. Helmed by a multi-disciplinary, dedicated team of healthcare professionals, CGH consistently delivers positive health outcomes for patients. For more information, visit www.cgh.com.sg
About Lucence
Lucence is a precision oncology company committed to bringing clarity to cancer care. Focused on developing total liquid biopsy for earlier cancer detection in a single blood draw, Lucence’s ultrasensitive liquid biopsy tests provide doctors and their patients with life-changing information. Lucence supplies personalized cancer care services through CAP-accredited and CLIA-licensed laboratories in California and Singapore. For more information, visit www.lucence.com.
[1] Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc. (2008) 83:584–94. doi: 10.1016/S0025-6196(11)60735-0