Liquid biopsy is rapidly becoming an indispensable tool in the oncologist’s arsenal; however, this technique remains elusive in a publicly funded healthcare system, and real-world evidence is needed to demonstrate utility and feasibility. Here, we describe the first experience of an in-house point of care liquid biopsy program at a Canadian community hospital. A retrospective review of consecutive cases that underwent plasma-based next-generation sequencing (NGS) was conducted. Liquid biopsy was initiated at the discretion of clinicians. Sequencing followed a point of care workflow using the Genexus™ integrated sequencer and the Oncomine precision assay, performed by histotechnologists. Results were reported by the attending pathologist. Eligible charts were reviewed for outcomes of interest, including the intent of the liquid biopsy, results of the liquid biopsy, and turnaround time from blood draw to results available. A total of 124 cases, with confirmed or suspected cancer, underwent liquid biopsy between January 2021 and November 2023. The median turnaround time for liquid biopsy results was 3 business days (range 1–12 days). The sensitivity of liquid biopsies was 71%, compared to tissue testing in cases with matched tissue results available for comparison. Common mutations includedEGFR(29%), in 86 lung cancer patients, andPIK3CA(22%), identified in 13 breast cancer patients. Healthcare providers ordered liquid biopsies to inform diagnostic investigations and treatment decisions, and to determine progression or resistance mechanisms, as these reasons often overlapped. This study demonstrates that rapid in-house liquid biopsy using point of care methodology is feasible. The technique facilitates precision treatment and offers many additional advantages for cancer care.
液体活检正迅速成为肿瘤学家不可或缺的重要工具，然而在公共医疗体系中该技术仍难以普及，亟需真实世界证据来验证其实用性与可行性。本研究首次报道了加拿大一家社区医院开展院内即时液体活检项目的实践经验。我们对连续接受血浆二代测序的病例进行了回顾性分析。液体活检的启动由临床医生自主决策，检测流程采用即时工作模式，由组织病理技术员使用Genexus™一体化测序仪配合Oncomine精准检测试剂完成，结果由主治病理医师审核签发。通过调阅符合标准的病历资料，我们重点分析了液体活检的应用目的、检测结果以及从采血到获取报告的周转时间。2021年1月至2023年11月期间，共有124例确诊或疑似癌症患者接受了液体活检。检测结果的中位周转时间为3个工作日（范围1-12天）。在与组织检测结果可对照的病例中，液体活检的灵敏度达到71%。在86例肺癌患者中最常见的突变是EGFR（29%），而13例乳腺癌患者中PIK3CA突变检出率为22%。医疗人员开展液体活检主要用于指导诊断评估与治疗决策，以及判断疾病进展或耐药机制，这些应用目的常存在交叉重叠。本研究证实，采用即时检测方法开展快速院内液体活检具有可行性。该技术不仅能促进精准治疗实施，还为肿瘤诊疗提供了诸多附加优势。
Point of Care Liquid Biopsy for Cancer Treatment—Early Experience from a Community Center
肿瘤(癌症)患者之家