Comparison of genomic profiling of circulating tumor DNA in plasma and bile from patients with pancreaticobiliary malignancies

Among patients with pancreaticobiliary cancer (PBCA), obtaining sufficient tumor tissue for genomic profiling has limitations. Liquid biopsies using plasma often do not provide sufficient sensitivity. A study in Japan compared bile versus plasma as source of ctDNA for genomic profiling. Oncogenic mutations were identified in 55% of patients in bile versus 24% of patients in plasma (p=0.005). Bile was significantly more sensitive than plasma for identifying druggable mutations (p=0.032). The authors conclude that liquid biopsy using bile may contribute to therapy choices in PBCA.