Digital Biopsies: Radiomics and Pathomics Are Important Stops on the Path to Precision Medicine – Cancer Therapy Advisor

The goal of finding a cure for cancer was eclipsed long ago by the need to identify and understand the wide variety of cancers and their subtypes, and the need to focus on developing therapies specific to different cancer mechanisms and challenges. With this understanding and the rise of immunotherapy and genomic sequencing, a vast chunk of current cancer research now focuses on finding biomarkers that can predict disease response to certain drugs and guide therapy protocols.

But single biomarkers genomic, molecular, orotherwise can only go so far in predicting responses given the complexity andheterogeneity of individual malignancies and their microenvironments.

The exploding field of genomics is advancing, andresearchers are starting to examine constellations of features that may bettercharacterize disease subtypes on the path to precision medicine, but genomicsalone cannot always distinguish differing phenotypes within cancer subtypes.

Hence, the rise of radiomics and pathomics, whichare fields that take a similar approach to genomics using technology to betterunderstand features of solid tumors.

We have been moving in the latest 15 years froman organ-based cancer treatment to [a] histology-based one, to the most recentprecision medicine, which means that we are going to treat the specificalteration of the tumor independently by the site where [it] arose, Giuseppe Luigi Banna, MD, of the UnitedLincolnshire Hospital Trust in Lincoln, United Kingdom, told Cancer TherapyAdvisor.

Dr Banna and his colleagues recently published apaper exploring the promise of digital biopsy for predicting immunotherapyoutcomes based on radiomics and pathomics.1 Although moleculardeterminants such as PD-1 or PD-L1 expression, and tumor mutational burden(TMB), are already used in clinical practice, these fail in consistency,applicability, or reliability to precisely identify the responding patientsmainly because of their spatial intratumoral heterogeneity, they wrote.

Dr Banna elaborated: The following 3 mainproblems with the current assessment of PD-L1 could be overcome by pathomicsand radiomics: the different platforms used to test it, the possibleinterobserver variability, and the dynamic changes in PD-L1 expression.

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Digital Biopsies: Radiomics and Pathomics Are Important Stops on the Path to Precision Medicine - Cancer Therapy Advisor