Colorectal Cancer Liquid Biopsy Testing
You Need a Complete Answer to Provide the Best Treatment
Available Biomarker Tests: KRAS, BRAF, NRAS
Standard treatment for advanced colorectal cancer generally involves surgical resection and chemotherapy. However, the recent emergence of targeted therapies, particularly those that inhibit EGFR, has provided treatment options that extend survival for a subset of patients. Unfortunately, this benefit does not extend to patients whose tumors contain mutations in EGFR signaling components KRAS, NRAS and BRAF, which together represent 50% of all colorectal cancers. This makes characterizing these molecular markers an important first step toward designing an optimal treatment strategy.
The NCCN, ASCO, CAP, AMP, and ASCP all provide guidelines for which patients should receive molecular profiling, when they should be profiled, and what colorectal cancer tests should be ordered.
Risks of Biopsy in Colorectal Cancer
Following the diagnosis of colorectal cancer, there is often insufficient tissue from the initial tumor biopsy to perform necessary molecular tests. Although attaining an additional tissue biopsy via colonoscopy is generally safe, the risk of a serious post-procedure complication remains a concern. A small number of patients will experience post-polypectomy bleeding, or even a bowel perforation. These risks are elevated in elderly patients.1 Because of this, many patients will be unwilling or unable to subject themselves to this procedure, particularly multiple procedures during the course of their treatment. Biocept’s liquid biopsy technology allows clinicians to non-invasively evaluate key biomarkers from a simple blood draw, providing information that can be used to guide therapeutic decisions.
Monitoring Tumor Evolution
Because tumors are generally heterogeneous, treatment with targeted therapies creates selective pressures that drive tumor evolution. For colorectal cancers, treatment with EGFR inhibitors can lead to outgrowth of tumor subclones that contain RAS or RAF mutations.2 Monitoring the molecular evolution of a patient’s tumor via serial liquid biopsies therefore provides critical information about tumor burden (e.g., the effectiveness of treatment and the onset of disease progression),3 as well as the mechanisms of acquired resistance. This information can then be used to rationally adjust treatment strategy.
Biocept and Liquid Biopsies – Completing the Answer
Whether you are unable to obtain sufficient tissue from a traditional biopsy, or you need to monitor treatment resistance without serial biopsies, a liquid biopsy test from Biocept can help complete the answer.
Biocept has developed the most advanced methods for isolating circulating cancer cells and fragments of tumor DNA from the blood. Our CLIA-certified and CAP-accredited laboratory then performs predictive biomarker testing to provide the most up-to-date biomarker status from a non-invasive patient blood sample. Validation studies have demonstrated that our technology has a high correlation between the biomarker status found in blood samples and traditional tissue biopsy.
How Does It Work?
A liquid biopsy from Biocept is a fast, easy way to establish biomarker status.
Step 1: Order a Biocept blood test. Your patient can get their blood drawn the same day, at any lab. Please contact customer service for Biocept Collection Kit supplies.
Step 2: The sample is sent via Fed-Ex to the Biocept lab. Our CLIA-certified, CAP-accredited lab isolates cancer cells and DNA fragments and uses analytically and clinically validated reagents to look for standard, clinically relevant biomarkers.
Step 3: Biocept’s liquid biopsy reports are provided to clinicians in approximately 5-7 days, in most instances this is faster than results performed on tissue, with the benefit of not having a surgical procedure.
Who Pays for a Liquid Biopsy? Biocept accepts all insurance and will bill on behalf of the patient. In addition, Biocept has a Financial Assistance Program (see Billing Policy), with payment plans available based on the patient’s financial situation. We are committed to excellence and are here to assist with any questions or concerns you may have. Please call 888.332.7729 M-F from 8-5 Pacific Time to discuss individual claims and policies.
1. Rabeneck, L. et al. (2008). Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology. 135, 1899–1906.2. Siravegna, G. et al. (2015). Clonal evolution and resistance to EGFR blockade in the blood of colorectal cancer patients. Nat. Med. 21, 795–801.
3. Frattini, M. et al. (2008). Quantitative and qualitative characterization of plasma DNA identifies primary and recurrent colorectal cancer. Cancer Lett. 263, 170–181.