We’re finding new ways to outsmart breast cancer every day, and a new technique is giving us a better head start on cancer’s next move. By picking up potential relapses earlier and helping scientists to see how someone’s cancer is behaving on a molecular level, the ‘liquid biopsy’ is making waves in breast cancer research.
Going with the flow
Biopsies traditionally involve surgery or needles to remove a sample of a someone’s , which is then analysed to learn more about their cancer. Liquid biopsies don’t require surgery, and work by fishing out bits of cancer that have made their way into a someone’s blood, urine or saliva.
Professor Nick Turner and his team at the Breast Cancer Now Toby Robins Research Centre at The Institute of Cancer Research (ICR) have been pioneering research into the use of liquid biopsy to detect breast cancer relapse and guide treatment for more than a decade.
Trickling down to the right treatment
From a small amount of blood, researchers have found a way to isolate the DNA that gets released by breast cancer cells. To separate this cancer DNA from other DNA in the blood, scientists look for the genetic changes that are only present in cancer DNA.
The changes that set cancer DNA apart are also what scientists want to analyse to learn more about someone’s cancer and better tailor their treatment. That’s because some, if not all, of these changes can drive cancer cells to grow or resist treatment.
Our researchers have been researching for years if we can use liquid biopsies to guide treatment. And recently, the SERENA-6 trial showed that using these blood tests in this way can have a clinical benefit. The trial found that giving some people with secondary breast cancer a new drug helped to keep people well for longer, and delayed the need for chemotherapy.
Moving upstream - predicting recurrence
Looking further into the future, liquid biopsies could also be used to get a step ahead of early breast cancer following a patient’s initial surgery for the disease.
Dr Turner explains: “What people are excited about in the future is whether techniques for secondary breast cancer can be used for . Recent results have shown we might be able to use the same test to see who isn’t cured and so needs further treatment after surgery.”
In this scenario, liquid biopsies could be used to get an indication that cancer is growing in the body before this is even detectable on scans or by symptoms. And in fact, Nick and his team have shown that liquid biopsies can detect breast cancer coming back many months before hospital scans.
Ultimately, researchers hope that if people can be offered treatment at this very early stage, it could be more successful than when it is currently given. And Nick and his team are investigating that too. In 2023, results from the c-TRAK TN trial demonstrated that liquid biopsies could potentially help doctors predict recurrence and guide treatment decisions for people with triple negative breast cancer.
Beyond stopping cancer there is also some evidence that we could one day use liquid biopsies as a screening tool to find cancer in the first place, although testing would have to get more robust and cheaper for this to happen on a large-scale.
Flowing into the future
The regular use of liquid biopsies in the clinic may be a few years off yet, but it’s clear why much is being made of this technique in the research world.
And what’s fuelling that excitement is hope - our hope to get ahead of cancer before it takes lives, and to outsmart it with the right treatment choices.
25 years of discoveries
This work is part of 25 years of ground-breaking discoveries at our research centre. Each one taking us closer to our vision that by 2050, everyone diagnosed with breast cancer will live, and be supported to live well.