Precise and Rapid Advanced Cancer Treatment Selection

February 15th, 2020

Rebecca Nagy, Vice President Medical Affairs, Guardant Health, Professor Clinical Internal Medicine, Licensed Genetic Counselor

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Time is of the Essence

For patients diagnosed with late-stage cancer, the longer treatment is delayed, the poorer the clinical prognosis,1-4 yet capturing a comprehensive picture of the disease is essential for determining the most appropriate first-line treatment. This is underscored by the fact that some 50% percent of advanced cancer patients will not survive long enough to undergo second-line therapy.5 When oncologists have the benefit of comprehensive genomic profiling (CGP), they are able to make optimal treatment decisions.6 Unfortunately, not all advanced cancer patients who could benefit from targeted therapies are being tested. For example, 80% of patients with advanced non-small cell lung cancer7 and 60% of patients with late-stage colon cancer do not receive guideline-recommended CGP.8

The Race Against Time

Genomic testing with tissue requires significant clinical resources, patient risk, healthcare costs, and time. Oncologists often order single-gene testing, intuiting that testing for fewer genes will require less time. However, this approach takes weeks because the tests are run sequentially. Furthermore, even when a broad tissue panel is ordered, 33% to 79% of the time tissue depleted, rendering “quantity not sufficient” (QNS), either due to actual specimen size, tumor cellularity, or both.9-11 The entire tissue testing process is lengthy, delaying treatment as disease progresses.

In addition to the health and survival implications, studies show that the process of waiting, in and by itself, can greatly increase anxiety and depression and diminish health-related quality of life for oncology patients.12,13

To address the urgency of the clinical circumstances, oncologists are often compelled to begin uninformed treatment while awaiting results. Consequently, patients are put on immunotherapy, chemotherapy, or both, despite many clinical studies indicating that biomarker-positive patients who receive the appropriate targeted therapy have greater progression-free survival rates and higher overall response rates.14-20

Treat at the Speed of Cancer

A blood test is less invasive, safer, and less painful. Research indicates that patients have a better experience with liquid biopsy over surgical biopsy.21 Beyond improving the patient’s quality of life, liquid biopsies are also easier for oncology practices by eliminating a myriad of logistical challenges associated with tissue.

Guardant360 CDx,22,23 the first comprehensive liquid biopsy approved by the FDA, provides guideline-recommended genomic results in 7 days, to facilitate rapid clinical decision making. The assay uses proprietary next-generation sequencing technology to simultaneously detect mutations in a broad panel of clinically-relevant solid tumor genes. Real-time notifications are sent when results are ready, so that providers can quickly see the report with matched therapy or clinical trial insights.

Leading with liquid biopsy circumvents the unpredictable and lengthy process of tissue testing, providing a minimally-invasive, swift, accurate, and repeatable alternative that has been FDA-validated. Indeed, as precision medicine continues to advance the practice of oncology, Guardant360 CDx liquid biopsy is quickly becoming the new standard of care.


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