The science and promise of liquid biopsies: improving cancer treatment

It was great to have the opportunity to reflect recently on how our approach to brain cancer diagnostics has moved forward and what the future looks like for this pioneering technology during a Chemistry World webinar entitled: ‘The science and promise of liquid biopsies: improving cancer treatment’

Brain cancer has been the cornerstone of our liquid biopsy research. It's the disease area where our solution is most advanced and where we've generated the most clinical evidence. Today we work with thousands of patients, but our journey began in 2013, focusing on signal differences between high-grade glioblastoma patients and control groups. We started by analysing 50 glioblastoma patients and 25 control patients to understand these differences[i]. From there, we expanded our research to include low-grade tumours, gaining deeper insights into the spectrum of brain cancer.

To make the results as robust as possible, we moved on to a prospective study aimed at capturing the most accurate population data. This work culminated in a double-blinded clinical validation study - the Brain ED studies [ii]- where we prospectively recruited 988 patients across NHS Lothian, with patients reporting to the Direct Access CT Scheme, the Department of Clinical Neurosciences, and A&E departments.

These sites were chosen as close proxies of primary care sample collection. Our target was the non-control group patients who presented with a history of non-specific symptoms such as headaches, dizziness, loss of memory, or seizures to their GPs. The real challenge lay in teasing apart the cancer signature from the multitude of neurological symptoms presented by these patients.

With our liquid biopsy solution, patients who had a positive disease prediction - indicating a risk for brain cancer - were referred for urgent imaging, while those whose predictions were negative were put on routine follow-ups, thus avoiding unnecessary imaging. This approach not only streamlines diagnosis but also alleviates pressure on health systems. The study consisted of a cohort of 603 participants and was non-interventional, so the patient treatment pathway was not impacted.

Building on this, we sponsored the EMBRACE study, which escalated our work to a European arena. This ongoing study aims to recruit 2,200 patients across seven sites to further test the novel approach that combines infrared spectroscopy and machine learning algorithms. This major study represents a significant advance in the refinement and scaling of our technology for broader application.

In parallel, we are exploring the technical capability of spectroscopy for the early detection of many cancers. Last year, we published a study on multiple cancers in the British Journal of Cancer. The study showcases how our technology can potentially bring about a revolution in the arena of early diagnosis of many types of cancers.

Liquid biopsies are one of the most promising opportunities in improving diagnosis and treatments of cancer. At Dxcover, we continue to advance the science behind this, push the boundaries on what can be achieved with early detection, and develop innovative technologies that help with rigorous clinical validation and the delivery of meaningful solutions to patients and clinicians.

I’m deeply proud of our team’s work and grateful for the opportunity to share our progress with the wider scientific community. Together, we’re paving the way for a future where cancer can be detected earlier, treated more effectively, and ultimately, where patient outcomes are dramatically improved.

[i] Hands et al. Anal. Bioanal. Chem. 2013, 405(23): 7347-55

[ii] Brennan et al. Brain Communications, 2021, 3 (2), fcab056; Cameron et al. Neuro-Oncology Advances, 2022, 4(1), vdac024