Peter Gibbs liquid biopsies

DYNAMIC-III trial could provide more effective screening

The potential of liquid biopsies in cancer screening will be tested in the DYNAMIC-III trial, which is currently recruiting patients. Liquid biopsies are a newer method of detecting the presence of tumours using blood tests rather than surgery. This trial has the potential to enable more fast and accurate cancer detection.

The DYNAMIC-III trial investigates the effectiveness of cancer detection by observing whether circulating tumour DNA (ctDNA) is present in a patient’s blood. When a tumour is present in the body, fragments of its DNA break off and circulate through the bloodstream. If ctDNA can be used to screen for the presence of a tumour, it could mean that cancer can be detected without the need for a biopsy.

The DYNAMIC-III trial specifically examines how detection of ctDNA could be used to improve the treatment of patients with stage III colon cancer. This is an advanced form of the disease, where the cancer has spread beyond the bowel and into lymph glands. Currently, patients with this type of cancer undergo surgery to remove the tumour, followed by three to six months of chemotherapy. Researchers are investigating the effectiveness of using ctDNA tests after surgery. This could determine whether patients with an absence of ctDNA after surgery can forgo stronger courses of chemotherapy.

Better screening can save lives

Chief Investigators Professor Jeanne Tie and Professor Peter Gibbs are leading the trial. Professor Gibbs says that although this technology will not have a significant impact on the survival of patients in the short term, it will help to secure safer and more comfortable screening. He also notes that the results of the DYNAMIC-III trial will be imperative to securing government funding into future research. In the long term, this could lead to national screening programs.

“Overall in terms of survival, screening will deliver the biggest impact,” says Professor Gibbs. “Ultimately if you can detect cancer that would not otherwise have been found in time then the patient may have the opportunity to go on to have curative surgery.”

If the results of the trial are positive, they have the potential to significantly improve the quality of life of patients with advanced colon cancer. Side effects of chemotherapy vary but they can be severe and include nausea, anaemia, fatigue, fertility problems, and hair loss. If the absence of a tumour can be detected before patients undergo this rigorous treatment, they will be excepted from a significant amount of discomfort and able to live more full and pain-free lives.