Oncologists pioneer liquid biopsy-guided treatment in lung cancer

Lung cancer is Australia’s leading cause of cancer deaths. Local experts are set to lead a new frontier in personalised lung cancer treatment, with new funding awarded to the ASPiRATION-2 Liquid (ASPiRATION-2L) clinical trial through the Medical Research Future Fund (MRFF).

Led by medical oncologists Professor Ben Solomon and Associate Professor Nick Pavlakis, in partnership with the University of Sydney and University of Melbourne, this innovative clinical trial aims to shift the paradigm in precision medicine by using serial liquid biopsies to guide treatment decisions in advanced lung cancer.

“The ASPiRATION-2L trial presents a unique opportunity to redefine personalised medicine for lung cancer using liquid biopsy with ctDNA to guide treatment decisions, not just at the time of diagnosis, but throughout the patient journey,” said Professor Ben Solomon.

In recent years, treatment of non-small cell lung cancer (NSCLC) has undergone a profound transformation. The discovery of specific genomic mutations that drive tumour growth has paved the way for targeted therapies that significantly improve survival and quality of life.

For patients with advanced oncogene-addicted NSCLC, the move from chemotherapy to targeted oral therapies taken at home has extended survival – some now living more than a decade post-diagnosis. However, the challenge of drug resistance remains a critical hurdle.

The ASPiRATION-2L trial will enrol 500 patients with advanced NSCLC who have developed resistance to these targeted treatments. By analysing circulating tumour DNA (ctDNA) in blood samples taken over time, researchers hope to continuously monitor tumour evolution and adjust treatment accordingly.

“Recognition of lung cancer in this way shines a much-needed spotlight on the challenges we face, and is a critical step forward in improving both research and patient outcomes. It also helps elevate lung cancer as a priority within the broader healthcare landscape, and I cannot wait to see this vision come to fruition!

“I am alive because of the research and advancements made in the field, and am privileged to still be here 10 years later, willing and able to work on this project,” said Lisa Briggs, Chief Investigator and Patient Advocate.

Currently, tumour profiling often relies on invasive tissue biopsies, which are not always feasible or safe for repeated sampling. Liquid biopsy – a minimally invasive blood test – offers a more practical option to track how tumours evolve and respond to therapy.

By building a real-time genomic profile, the ASPiRATION-2L approach aims to move beyond empirical therapies and implement genomically-directed treatment strategies. This could support a shift in metastatic NSCLC management – treating it as a chronic condition with improved outcomes, fewer side effects, and reduced exposure to ineffective treatments.

“Over the past decade, significant progress has been made in treating lung cancers, with highly effective therapies being selected at the time of diagnosis based on genomic testing of tumour tissue,” Professor Solomon stated.

“The ASPiRATION-2L trial presents a unique opportunity to redefine personalised medicine for lung cancer using liquid biopsy with ctDNA to guide treatment decisions, not just at the time of diagnosis, but throughout the patient journey.”

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