6 November 2019 0 By Roberto Pugliese

In these last days the news about the results of the research coordinated by Erica Carpenter at the Abramson Cancer Center of the University of Pennsylvania and published in the scientific journal Clinical Cancer Research have multiplied.

The news was taken up by Repubblica and Messaggero. Outside Italy the news appeared in PhillyVoice, DailyMail, but also in HemOncToday, MedicalDeviceNetwork and NewsMedical.

The Italian newspapers stress the fact that the coordinator is Italian and the other on the fact that glioblastoma is the tumor that affected Senator John McCain who has been running for the White House. Both things are true!

The simultaneous appearance of the news on all these journals means that the research is important but it will take time before the method could be applied on a global scale and become a medical practice, considering that it is a clinical study.

This study involved 42 patients with newly diagnosed Glioblastoma Multiforme. Patients performed blood tests at diagnosis, before surgery and at regular intervals during standard chemotherapy and radiotherapy cycles. The 28 patients with a lower concentration of free tumor DNA in the blood observed almost double the progression-free survival (median 9.5 months) compared with 14 patients with higher concentrations (median 4.9 months). In a secondary analysis of 20 patients, the liquid biopsy found at least one mutation in 11 patients and all these mutations were different from those found in the biopsy analysis of each patient’s solid tumour.

The authors state that the detection of further mutations is particularly important, as an effective therapy for glioblastoma requires a combination of therapies due to the tumour heterogeneity. If the liquid biopsy can give us a more complete view of the molecular profile of the tumor, we can use the most effective therapy for each patient.

The trial will now go on involving more patients and performing tumor DNA sequencing to find out the complete molecular profile of each.

This research, which still has years before becoming practical, tells us some important things, namely that in the future (1) probably less invasive liquid biopsies will be performed, (2) sequencing of the tumor DNA will be done for knowing the complete profile and choosing the best therapy and (3) that is now known that glioblastoma evolves and that it cannot be treated without a combination of possibly concurrent treatments, that can change over time to follow the profile of the tumor’s DNA.