NEW YORK – The Ivy Brain Tumor Center at Barrow Neurological Institute on Wednesday said it has begun a liquid biopsy program to assess how patients' cancers respond and adapt to investigational therapies in real time.

The Ivy Brain Tumor Center has developed a liquid biopsy technique that involves placing a biologically inert reservoir under the patient's scalp during tumor surgery. The reservoir is attached to a small catheter in the tumor resection cavity, so that when patients come in for routine checkups, physicians can extract a CSF sample from the reservoir using a sterile needle. The sample is then analyzed for tumor-specific DNA and RNA markers and compared to prior samples to determine whether a patient is developing resistance to treatment. 

Researchers within the Ivy Brain Tumor Center's Phase 0 clinical trials will use this method to track changes in patients' brain tumor biology month to month. They hope to pick up on biological changes associated with treatment response and resistance that can't be seen in imaging. 

"Early liquid biopsy efforts have focused on using blood or cerebrospinal fluid samples to ascertain tumor diagnosis," Nader Sanai, director of the Ivy Brain Tumor Center, said in a statement. "We are developing the next generation of this platform to track tumor evolution in the face of experimental therapy." If liquid biopsies reveal that patients' brain tumors are adapting to a given treatment, then researchers can use that information to develop therapeutic strategies to counter that resistance, Sanai added.

The first patients to have access to this liquid biopsy procedure will be those with newly diagnosed glioblastoma enrolled in a Phase 0 trial, in which researchers are assessing if GlaxoSmithKline's Zejula (niraparib) can cross the blood-brain barrier. Around 13,000 patients are diagnosed with glioblastoma each year, making it the most common type of brain cancer. There's a need for new treatment strategies in this setting, since around 70 percent of patients are likely to develop resistance to available therapies, and nine out of 10 patients don't live for five years after diagnosis.

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