Researchers have found that liquid biopsies may be able to detect the blood disorder clonal hematopoiesis, which places patients at higher risk of developing blood cancers. The findings were presented at the 2022 European Organisation for Research and Treatment of Cancer (EORTC)–National Cancer Institute (NCI)–American Association for Cancer Research (AACR) Symposium on Molecular Targets and Cancer. Researchers at the Institut Gustave Roussy, Villejuif, France, investigated whether these biopsies could also be used systematically to identify patients who either have or could be at higher risk of developing myelodysplastic syndrome or acute myeloid leukemia.
Between March and October 2021, researchers took liquid biopsies from 1,416 patients with a range of solid tumors who had enrolled in the Gustave Roussy Cancer Profiling study (STING). Marco Tagliamento, MD, of the Institut Gustave Roussy, commented: “We found that 113 patients, 8%, had at least one clonal hematopoiesis mutation that could be considered to place them at higher risk of developing blood cancers during their life. Out of these patients, 45 were referred to our hematology unit by their oncologist and 5 were subsequently diagnosed with blood cancer: one with myelomonocytic leukemia, two with myelodysplastic syndrome, and two with essential thrombocythemia.”
The Value of Early Detection
The researchers believe that when liquid biopsies reveal a high-risk clonal hematopoiesis feature in patients, this should trigger further hematologic evaluation in some circumstances to reveal the actual risk of developing a blood cancer or to uncover cases where a patient already has one. “Early detection could prevent complications during anticancer treatments—for instance, alterations to blood counts—and consequent interruption or delay to treatment. It could also indicate possible diagnostic and therapeutic pathways for doctors to consider for hematologic disease,” Dr. Tagliamento said.
During the work to identify patients who should be referred for further investigation, each case was considered carefully by the Gustave Roussy Molecular Tumour Board to identify the genetic mutations involved in clonal hematopoiesis. “Case-by-case evaluation is crucial,” said Dr. Tagliamento. “Different aspects must be considered when evaluating the potential impact and management of high-risk clonal hematopoiesis in patients who already have cancer. These relate, for example, to the patients, their medical history, and to the underlying cancers. All of them should be part of a balanced evaluation made for each individual case.”
Tagliamento M et al: EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics. Abstract 22. Presented October 28, 2022.
