Moores Cancer Center; Genome Sequencing and Liquid Biopsy
Science + ResearchOur Latest News and Research (April 2018)
Since our story at the Moores Cancer Center in San Diego there have been many exciting developments with liquid biopsies. Liquid biopsies are great for monitoring patients who are already diagnosed with cancer, but the aim for everyone working in the industry is to find a test which can accurately diagnose cancer in previously asymptomatic or seemingly healthy patients. That’s the goal of companies like Biocept, Vortex Bio, Clearbridge BioMedics, Grail, and CellMax Life.
CancerSEEK
A new test called CancerSEEK, looks for the presence of eight different types of cancer including lung, breast and colorectal cancers all at the same time. Those three are together responsible for more than 60 percent of cancer deaths in the U.S. The proposed cost for the test is $500. A good video on CancerSEEK can be seen here at MSN. A helpful and informative article we found can also be read here on the Blood Test that Detects Several Cancer Types.
But blood-based “liquid biopsy” tests have been hit with recent controversy about their ability to accurately detect cancer mutations as covered by Forbes here.
VIDEO TRANSCRIPTION
Kaushal Patel: It’s a breakthrough that oncologists could never have envisioned even just a few years ago, looking for the answers to cancer in a vial of blood. Here at the Moores Cancer Center in San Diego, ongoing clinical trials on liquid biopsies are showing to be very promising.
Rosina Reyes: I feel good.
Kaushal: Rosina Reyes feels like a walking miracle.
Rosina: I feel happy to be alive every day.
Kaushal: She was given six months to a year to live after she was diagnosed with lung cancer. That was nine years ago.
Rosina: No, I never smoke.
Kaushal: Oncologists removed one of her lungs after finding a golf-ball-sized tumor. It’s been a gruelling journey of treatments – chemotherapy, radiation – and for the last seven years, Reyes has been on the drug Tarceva.
Rosina: I have a new growth in my good lung.
Kaushal: Reyes’ cancer has been changing the way it reacts to her medication.
Dr. Hatim Husain: Okay, perfect.
Kaushal: Through a blood and urine liquid biopsy, her doctor learned something Reyes’ tissue biopsy didn’t show.
Dr. Husain: You had the tissue biopsy, which was negative, but in the blood and in the urine, we were able to detect positivity.
Kaushal: Dr. Hatim Husain is leading some of the clinical trials on liquid biopsies.
Dr. Husain: We put the tubes over here in the centrifuge. We spin it.
Kaushal: Hundreds of blood biopsies have been performed at the UCSD Moores Cancer Center in San Diego. Similar studies have been done with urine.
Dr. Husain: As patients are receiving different forms of therapy, we believe that the cancer is not staying static. It actually changes. So, making decisions on the basis of the initial biopsy may only provide an incomplete picture because the cancer’s changing on top of the different therapies.
Kaushal: Back in the ’80s, one of the top scientists in the world, Bert Vogelstein at Johns Hopkins University, helped prove damaged DNA is the cause of cancer. Since almost every type of cancer sheds DNA into the bloodstream, his lab created liquid biopsy technologies to look for mutations in cancer.
Dr. Razelle Kurzrock: This liquid biopsy, potentially, could test for any cancer.
Kaushal: Researchers can spot the DNA of a tumor, sometimes even in trace amounts, in blood, saliva, urine, and other fluids.
Dr. Kurzrock: What you see here is a tumor.
Kaushal: This may be used for early detection, and also monitoring therapy to figure out potential reasons why drugs may stop working.
Dr. Kurzrock: Because it’s so simple, it can be repeated. So, I can envision a time where we repeat the liquid biopsy every time we do scans to see if the tumor is getting better. We don’t know yet whether or not we can actually eliminate the tissue biopsies. We’re still seeing information in the tissue biopsy that the blood biopsy is not sensitive enough to detect.
Kaushal: Liquid biopsies are just one of the practical applications to advancements in genome sequencing.
Dr. John Leite: The technology has reached a certain point now where we can run through millions and millions of sequences in a very small period of time with extremely high sensitivity and accuracy, and that’s really what’s enabled this entire market to pop up.
Kaushal: Illumina, based in San Diego, leads the world in making the sequencing machines which have allowed doctors and researchers to look for answers to cancer in a vial of blood.
Dr. Leite: And it’s opening up the doors for new therapies, new interventions. Liquid biopsy is just one of the many exciting things happening.
Kaushal: The promise of these tests is clear. The problem, studies are still ongoing, and they only involve small numbers of patients. There are no big, definitive studies to show their full potential. For that reason, liquid biopsies are being offered to those who already have cancer. The test still has some hurdles to overcome to be used as a mainstream screening tool.
Dr. Kurzrock: Because it turns out that there may be abnormalities that are present in the blood of normal people, and because they have a good immune system or for other reasons, they never develop cancer. So, the prevention strategies, while the most exciting, are probably also the most challenging.
Kaushal: Several companies are working on liquid biopsy tests. One California company has been selling the tests for $5,400 since last June. Insurance companies, under certain situations, cover liquid biopsies, which may transform cancer treatment. And, ultimately, Reyes hopes it will improve the lives of patients like her down the road.
Rosina: And I thank God for the scientists here, working hard. And thanks God to them because, at least, I have a hope.
Kaushal: Kaushal Patel, San Diego Union-Tribune.
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