Baptist Health First in State to Conduct Novel Liquid Biopsy in Brain Cancer Patient

As part of an international clinical trial, Miami Cancer Institute and Miami Neuroscience Institute, part of Baptist Health South Florida, have conducted the first low-intensity focused ultrasound (LIFU)-aided liquid biopsy in the state of Florida in a patient with glioblastoma, according to researchers at both institutes who are leading the study.

Glioblastoma is the most aggressive form of brain cancer, they note, and biopsies in patients with brain cancers are challenging as they often require invasive procedures. This ongoing study aims to show that LIFU is a viable way of increasing circulating tumor DNA (ctDNA) in the blood, allowing for non-invasive detection of glioblastoma.

Manmeet S. Ahluwalia, M.D., MBA, FASCO deputy director, Fernandez Family Foundation Endowed Chair in Cancer Research, chief of medical oncology, and chief scientific officer of Miami Cancer Institute

“Unlike other types of malignant lesions, brain cancers are more difficult to detect in the blood because of a protective lining in the brain – the blood-brain barrier – that prevents tumor DNA from moving into the bloodstream,” explains the study’s national principal investigator, Manmeet S. Ahluwalia, M.D., MBA, FASCO deputy director, Fernandez Family Foundation Endowed Chair in Cancer Research, chief of medical oncology, and chief scientific officer of Miami Cancer Institute. “The traditional way to understand the genomics of tumor progression is to operate on them, which can lead to increased risk of side effects such as bleeding in the brain, infections, or both.”

Dr. Ahluwalia calls the study “incredibly exciting and important” as it has the potential to alter how tumors are followed in patients with brain tumors. Liquid biopsies measure ctDNA in a patient’s blood and are already common for various other forms of cancer. Because of the mechanism of the blood-brain barrier, they have so far been less utilized for patients with brain cancers. LIFU, however, temporarily disrupts how the blood-brain barrier works and allows tumor DNA to leak into the bloodstream, making it detectable in liquid biopsies.

Patients enrolled in this trial have blood drawn before and after the non-invasive LIFU procedure. In addition, they all go through traditional surgery. The results are then compared, and investigators hope to be able to determine whether the ctDNA found in the patients’ blood corresponds to that found in the tumor cells that were surgically biopsied.

Michael W. McDermott, M.D., neurosurgeon and chief medical executive of Baptist Health Miami Neuroscience Institute

“For the patient, a LIFU liquid biopsy is a vastly different experience than having to go through a surgical biopsy,” said Michael W. McDermott, M.D., neurosurgeon and chief medical executive of Baptist Health Miami Neuroscience Institute, who conducted the LIFU biopsy on the first Florida patient. “This outpatient procedure, which is non-invasive, took two hours, and the patient felt great after. He was able to leave after six hours of monitoring. It is quite remarkable.”

According to Dr. Ahluwalia, a huge benefit of a liquid biopsy is that the patient can receive cancer treatment as soon as the result of the liquid biopsy is available, whereas after a surgical biopsy, they often have to wait up to three to four weeks to begin treatment.

“Ultimately, we hope LIFU liquid biopsies become an integral part of glioblastoma management,” says Dr. Ahluwalia. “They may help measure treatment success or give clues when a therapy is not working, without having to go through invasive surgical biopsies that are associated with significant risk. It will also be a much less stressful experience for the patient.”