Genomic profiling via liquid biopsy may provide a less invasive alternative to traditional tissue sampling for high-risk localized prostate cancer. This approach is particularly beneficial when tumor tissue is limited or of poor quality.
While liquid biopsies, which analyze circulating tumor DNA (ctDNA) in blood, are used for metastatic prostate cancer, their application in localized disease was uncertain due to typically low ctDNA levels.
A phase 2 study compared tissue- and plasma-based genomic profiling in patients with high-risk localized disease. Researchers analyzed DNA from tumor samples and plasma using advanced platforms.
The study found significantly higher success rates with liquid biopsies. Only 54.5% of tissue samples yielded usable genomic data, often due to insufficient DNA. In contrast, all 27 plasma samples were successfully sequenced.
Both methods identified a similar average of 3.5 genomic alterations per sample, including key genes like SPOP, ATRX, ATM, and ARID1B. Liquid-based profiling demonstrated superior depth and coverage, enabling detection of low-frequency mutations potentially missed by tissue analysis.
Direct comparison between matched tissue and plasma samples was limited. However, the study indicates liquid biopsy is feasible and technically robust for high-risk localized prostate cancer, potentially serving as a valuable complementary tool where tissue biopsies are inadequate.
Larger studies are needed to confirm concordance and integrate liquid biopsy findings into clinical decision-making for localized disease.