Liquid Biopsy Expands Insights Into Treatment Response and Tumor Alterations

Treatment selection in advanced breast and lung cancers can be challenging when traditional biomarkers are absent and genomic findings alone do not fully clarify which therapies may be effective. To provide a broader view of tumor biology, a newly introduced set of applications combines genomics, epigenomics, and artificial intelligence to help assess how an individual patient’s cancer may respond to treatment.

Guardant Health has introduced new applications for Guardant360 Liquid, expanding the test’s capabilities for treatment selection in breast and lung cancers. The applications are powered by InfinityAI, the smart platform supporting Guardant’s next-generation cancer tests. The expanded capabilities include two epigenomic predictors designed to identify patients who may benefit from selective estrogen receptor degraders in advanced breast cancer or immune checkpoint inhibitor monotherapy in advanced non-small cell lung cancer.

Image: Guardant Health has introduced new applications for Guardant360 Liquid, expanding the test’s capabilities for treatment selection in breast and lung cancers. (Photo courtesy of Guardant Health)

Guardant360 Liquid will also incorporate epigenomic identification of patients with non-small cell lung cancer who are programmed death ligand 1 (PD-L1) negative without requiring a tissue sample. For immunotherapy assessment, the lung cancer application combines epigenomic characterization of the tumor microenvironment with tumor mutational burden and microsatellite instability to evaluate the likelihood of benefit from immune checkpoint inhibitor monotherapy versus chemoimmunotherapy. 

In breast cancer, the selective estrogen receptor degrader application is intended to support treatment decisions for patients with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative disease progressing after first-line therapy, including those without an ESR1 mutation.

Additional epigenomic features identify 20-45% of anaplastic lymphoma kinase (ALK) fusions and more than 250% more MTAP deletions missed by genomic liquid testing alone. The MTAP deletion application is positioned to evaluate new targeted approaches, including PRMT5 and MAT2A inhibitors, to help inform clinical trial enrollment in advanced lung cancer. By incorporating insights across genomics and epigenomics, Guardant360 Liquid is designed to provide a more complete view of cancer and support increasingly individualized treatment decisions.

“By bringing genomics, epigenomics and AI together, Guardant is trailblazing a new standard of oncology care. Our goal is to translate deeper biological insights into practical information that gives physicians greater confidence in treatment decisions and brings us toward the fulfillment of what precision medicine can be,” said Helmy Eltoukhy, Guardant Health chairman and co-CEO.

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