Reveal More with cfDNA + cfRNA
Liquid GPS is a blood-based molecular test that provides oncologists with a powerful tool for noninvasive tumor profiling and quantitative monitoring of treatment response. Liquid GPS looks beyond cfDNA to cfRNA, which allows profiling and trending of actionable biomarkers that cannot be assessed through cfDNA alone. In addition to providing molecular insight into key guidelines-based biomarkers (e.g., EGFR T790M, ALK, ROS1, KRAS), this powerful RNA-based approach enables a variety of capabilities and applications not typically available from a liquid biopsy test.
Inform and Evolve Treatment
Monitor and inform treatment when tissue is unavailable.
Reveal More Information
Go beyond cfDNA with cfRNA expression.
Easy, Fast, Noninvasive
Get molecular insights in <7 days with a simple blood draw; no special processing at point-of-care – send at room temperature.
Key Applications of Liquid GPS
Targeted therapy monitoring – including ALK and ROS1 by cfRNA In addition to assessing guideline-recommended mutations (e.g., EGFR T790M, BRAF, KRAS, and NRAS), Liquid GPS provides cfRNA-based testing and monitoring for gene fusions and translocations (i.e., ALK, ROS1). RNA has also been shown to be a more accurate indicator of fusions and translocations compared to DNA, which can miss or incorrectly classify gene fusions.1
Immunotherapy monitoring – PD-L1, CTLA4, LAG3, and TIM3 With immunotherapy increasingly becoming a central component of care in many cancers, molecular tools are evolving to give oncologists new and earlier insights into their effectiveness in each patient. Liquid GPS includes 4 analytes associated with approved and investigational immunotherapies – PD-L1, CTLA4, LAG3, and TIM3. PD-L1 via Liquid GPS’s cfRNA analysis has been demonstrated to correlate to measurement by IHC, as shown to the right.2 Not only can this information inform an oncologist’s initial treatment selection, it can also be used to monitor response over time. In fact, blood-based PD-L1 assessment has been shown to objectively differentiate between true progression and pseudoprogression, which may help to avoid erroneously changing treatment due to pseudoprogression.3
Chemotherapy monitoring Liquid GPS includes 11 analytes associated with response or resistance to commonly used chemotherapies, including ERCC1 to inform use of platinums and TUBB3 to inform use of taxanes.
AR-V7 testing in prostate cancer Pill-based, androgen-directed therapies abiraterone and enzalutamide are increasingly used by both medical oncologists and urologists to manage patients with metastatic castration-resistant prostate cancer (mCRPC). In fact, these two drugs are often used sequentially. How do you know if your patient is unlikely to respond? AR-V7 has been shown to strongly predict resistance to both abiraterone and enzalutamide.4 AR-V7 positive patients are unlikely to respond to these drugs, and may be more likely to benefit from other treatment strategies, such as taxane chemotherapy.5 Up to 12% of mCRPC patients are AR-V7 positive prior to therapy with either abiraterone or enzalutamide, and therefore, likely to be resistant. Up to 25% are AR-V7 positive after treatment with one of these drugs. Liquid GPS is the only liquid biopsy that assesses AR-V7 via cfRNA. Compared to assessing AR-V7 in circulating tumor cells (CTCs), analysis through cfRNA has demonstrated improved sensitivity, and may allow detection in less advanced disease, prior to the point when CTCs are detectable in the blood (e.g., tumors confined to bone metastases).6
If you would like more information or assistance with the ordering process, please contact the GPS Care Center at 1-844-MY-OMICS or email us at GPS@NantHealth.com.
1 Zhang et el. Comparison of genomic DNA and cDNA for detection of residual disease after treatment of chronic myeloid leukemia with allogeneic bone marrow transplantation. Blood. 1996 Mar 15;87(6):2588-93. 2 Ishiba T et al. Frequencies and expression levels of programmed death ligand 1 (PD-L1) in circulating tumor RNA (ctRNA) in various cancer types. Biochem Biophys Res Commun. 2018 Apr 27. pii: S0006-291X(18)30899-4. 3 Lee JH, Long GV, Menzies AM, et al. Association Between Circulating Tumor DNA and Pseudoprogression in Patients With Metastatic Melanoma Treated With Anti–Programmed Cell Death 1 Antibodies. JAMA Oncol. Published online February 08, 2018. doi:10.1001/jamaoncol.2017.5332 4 Antonarakis et al. AR-V7 and Resistance to Enzalutamide and Abiraterone in Prostate Cancer N Engl J Med 2014;371:1028-38. 5 Scher et al. Association of AR-V7 on Circulating Tumor Cells as a Treatment-Specific Biomarker With Outcomes and Survival in Castration-Resistant Prostate Cancer. JAMA Oncol. 2016 Nov 1;2(11):1441-1449. 6 Cho WJ et al. Gene expression analysis of bone metastasis and circulating tumor cells from metastatic castrate-resistant prostate cancer . J Transl Med. 2016; 14: 72.