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  1. #1
    Claire Louise's Avatar
    Location of employment
    Lung Foundation Australia
    Join Date
    6th August 2015
    Last Active
    11th April 2017

    Reply to Liquid Biopsies

    As promised from last weeks post regarding liquid biopsies in Australia, I spoke with a leading molecular pathology scientist who provided the following information, which I hope helps answer your questions.
    Liquid biopsy is a new development in individualised cancer treatment and is an emerging technique which offers a non-invasive approach for identifying gene mutations.
    Further clinical trials must be done nationally and internationally to assess the effectiveness of liquid biopsy and this is ongoing, both within Australia and internationally, especially in lung cancer
    Currently reimbursement for liquid biopsy within Australia only applies if a patient has EGFR positive disease that has relapsed they can be tested by a liquid biopsy for the T790M mutation.
    Overseas, for example in the USA, a patient diagnosed with lung cancer may receive funding for a liquid biopsy through their insurance scheme and private suppliers. The current cost for a liquid biopsy that will test for many gene alterations is approximately $5000 US.
    If the results of the ongoing research demonstrate the usefulness and cost effectiveness of liquid biopsy compared to a tissue biopsy, then the hope is that this non-invasive alternative for identifying genetic alterations will become established, as an accurate and effective test, as part of mainstream practice in diagnosing lung cancer.
    The field of diagnostics and treatment in lung cancer has moved incredibly quickly in recent years and the next few years will be critical to demonstrate the benefits of this new test to increase its uptake.
    Below are links to the Olivia Newton John Cancer Centre that will provide further information on Liquid biopsies.

    Claire Mulvihill
    Lung Cancer support nurse
    Lung Foundation Australia

  2. #2
    cind po's Avatar
    Location of employment
    Join Date
    8th January 2017
    Last Active
    1st February 2017
    Hi Claire,

    Thank you for your effort in doing all the research. Really appreciate it.

    I am already aware of the cost of the Foundation One testing (using tissue as a sample-$4600) and Liquid Biopsies (using blood as a sample-cost varies depending on the company) to test for mutations. I have also been in contact with a Molecular Pathology scientist and have been made aware of the services offered by one of the Molecular Pathology labs in Australia. We do not have liquid biopsies but we do have Next Generation Sequencing which is in line with what Foundation One does. I have also been made aware that the T790M testing is still currently under validation and is not available for routine testing yet.

    The problem is that patients who want these test to be performed are having a hard time because hospital staff make it sound like it is so hard to do. The oncologist just request this test online, then the company sends the oncologist the kit and there is an instruction on how to send it back. I was a bit confused why the oncologist we are seeing could not do this. And that's what prompted me to post this. The real issue is how to build a bridge between these companies and the patients in Australia wanting to avail of their services.

    INIVATA (UK & US) is currently running a trial for liquid biopsies until July. They (INIVATA) are aware that this is not a approved test in Australia hence the need for a clinician referral. The test will be perfromed under research and courier will collect and manage packaging and labelling. I have already made peace with the fact that our team is not willing to do this and so we will get a referral from another oncologist if the team will not change their mind when we're ready to do this. I hope this will be useful for those thinking of doing liquid biopsies. I was never aware these test existed before.

    There have been a few cases where the initial biopsy using tissue as a sample tested negative for a particular mutation and then when tested with a blood biopsy, it tested positive.

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