Development of selection strategies for Homologous Recombination Deficient (HRD) patients utilizing a Liquid Biopsy

Metastatic cancer is an evolving, heterogeneous disease that becomes more complex over time through the selection of sub-clonal tumor populations both in response to therapy and to disease progression. Clonal evolution necessitates evaluation of disease progression at the single cell level to better understand the heterogeneity of the disease and provide treatment options to maximize therapeutic efficacy.  To that end, we have developed a single cell liquid biopsy test to characterize patient’s CTCs for HRD status, which can be used to predict sensitivity to PARP inhibitors and/or other DNA repair targeted therapeutics. Utilizing our no cell left behind® technology, we have developed a propriety algorithm that predicts the presence of genomic scarring, a marker of HRD, based on high content image analysis of each cell’s phenotypic features. Based on the prevalence of HRD CTCs, we demonstrate the potential of the test to guide therapy.