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DeciBio Liquid Biopsy Weekly Digest
May 19th, 2020
Foundation Medicine, Flatiron, and Genetech launched their Prospective Clinico-Genomic (PGC) study on Monday. This trial will pair real-world evidence generated by ~1000 lung cancer patients (collected via Flatiron) to genomic information gained through serial liquid biopsy (via Foundation's LBx) to identify genomic markers of resistance and treatment response for improved therapy development (via Genetech). Tapping into real-world data has the potential to enhance clinical trials by expanding the patient pool, and linking the data to patient outcomes outside of the trial setting. Interest in real-world evidence is apparent in other liquid biopsy leaders. Alongside of Lunar-1 and Lunar-2 updates, Guardant will be presenting data demonstrating the value of their GuardantINFORM platform at ASCO 2020 and AACR 2020 Meeting II. GuardantINFORM links real-world evidence to patients who underwent serial Guardant360 ctDNA testing. Little is publically known about GuardantINFORM and we are curious to learn more about this platform.

Smaller companies have also been generating data and are active in the LBx space. Lexent Bio published proof on concept data for their blood-based whole-genome assay, Confera Dx in Molecular Cancer Therapeutics this week. Confera is intended to detect response to systemic therapy in advanced cancers within a few weeks of treatment initiation in order to determine if a patient should stay on or consider switching therapies. By accelerating response detection, Confera Dx could help patients save in monetary and opportunity costs (i.e., time) of ineffective therapy. Further validation is needed, but molecular progression calls via Confera's whole genome and methylation sequencing showed 54% sensitivity and 100% specificity. Additionally, patients with identified major molecular response also showed significantly improved PFS and OS compared to patients without molecular response. Lexent's tool can not only improve how patients are treated but can be used to assist biopharma in understanding treatment resistance for new anti-cancer treatments. VolitionRx will present data on their epigenetic diagnostic assays for lung and heme cancers. VolitionRx's Nu.Q platform uses the length of fragments found in nucleosomes to isolate tumor-derived nucleosomes (shorter fragments) from normal cell-derived nucleosomes (longer fragments). This enrichment step allows for a more accurate measurement of cancer nucleosomes which could lead to diagnostic assay development. Bellweather Bio, which also studied circulating DNA fragments, was acquired by Guardant about a year ago for an undisclosed amount.

There are several other exciting stories this week, including a paper published in JCO Precision Oncology which provides further information on how tumor burden over time impacts concordance between liquid and tissue biopsy samples. Be sure to check them out!

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