Liquid Biopsy in Glioblastoma Multiforme

It often happens that we decide to write an article stimulated by patient requests. Sometimes, as in this case, the suggestion also comes from specialists who wish to inform patients of a new opportunity.

It was also recently published in the Journal of Neurooncology a very interesting retrospective study: The detrimental effect of biopsy preceding resection in surgically accessible glioblastoma: results from the national cancer database.

This study focused on glioblastoma (GBM) patients with the aim of understanding whether performing a biopsy before surgical removal of the tumor influenced patient outcome. The researchers examined data from 17,334 GBM patients between 2010 and 2014. The study suggests that for patients with a surgically accessible glioblastoma, undergoing resection surgery directly rather than undergoing a biopsy first could lead to better outcomes in terms of survival.

Liquid biopsy is a new technique that is changing the way glioblastoma multiforme is diagnosed and treated. Instead of obtaining tumor samples through surgery, this technique allows the genetic characteristics of the tumor to be detected through a simple sample of blood or cerebrospinal fluid (the fluid that surrounds the brain and spinal cord).

Understanding tumor-specific genetic mutations can help us understand how the disease is progressing and how it might respond to certain treatments. This is especially important for glioblastoma, as it is often difficult to access the tumor to take samples directly due to its location in the brain. The content of the article cited above further strengthens this position.

The central technology behind liquid biopsy is the analysis of circulating tumor DNA (ctDNA), which is DNA released from tumor cells into the blood or cerebrospinal fluid. Despite its benefits, liquid biopsy still has challenges to overcome, such as the low amount of ctDNA that can be detected and difficulties in molecular analysis.

The liquid biopsy technique is not yet widely approved for all types of cancer, but it is becoming common practice for some, such as lung cancer. While it is not yet standard practice for glioblastoma, there are hopes that it could become a useful tool in the future, especially for monitoring response to treatments and changes in the tumor over time.

In the case of brain tumors, such as glioblastoma, there are additional complications due to the presence of the blood brain barrier, a barrier that protects the brain but can prevent ctDNA from easily passing into the blood. This makes it more difficult to detect genetic mutations in the tumor.

Some new, less invasive methods are being studied to improve ctDNA detection, such as drawing blood from specific veins closer to the brain. These developments could significantly improve the diagnosis and monitoring of glioblastoma in the future.

For further information on the topic (both from patients and specialists) and on the possibilities of using this approach to liquid biopsy, do not hesitate to contact Prof. Bruno Damascelli’s team (references at the bottom of this article) who with the help of the Falciani ONLUS Foundation is carrying out clinical trials on liquid biopsy with blood sampling from specific veins closest to the brain and is able to carry out complete NGS (Next Generation Sequency) molecular analysis on the samples taken in order to effectively detect potential mutations target of personalized treatment.

In summary, liquid biopsy offers new hope for a less invasive and more effective way to understand and treat glioblastoma, although there are still challenges to overcome before it becomes standard practice.

Alberto Gramaglia, Head of Radiotherapy at the Monza Polyclinic,
Vladimira Tichà, Fondazione Falciani ONLUS, Milan,
Bruno Damascelli, Fondazione Falciani ONLUS, Milan,