With only a few drops of blood, we can pinpoint the unique genetic make-up of various cancer.
A new blood test developed by scientists at the Vancouver Prostate Centre offers doctors previously unknown insight into a patient’s cancer makeup, perhaps enabling them to choose treatments that would result in better patient outcomes.
A report published today in Nature described the technology.
The ground-breaking blood test examines circulating tumor DNA, or ctDNA, which is the DNA that metastatic tumors release into the circulation. The test exposes traits that are particular to each patient’s cancer by sequencing the full genome of this ctDNA, offering doctors more resources to create more specialized treatment regimens.
Dr. Alexander Wyatt, research scientist with the Vancouver Coastal Health Research Institute (VCHRI) and BC Cancer, says “With only a few drops of blood, we can uncover critical information about a person’s overall disease and how best to manage their cancer.”
This test has the potential to assist clinicians in selecting better-tailored treatment options and detecting treatment resistance more effectively, allowing clinicians to change clinical care as necessary.
The study’s authors looked at ctDNA samples obtained from men who had metastatic prostate cancer. Cancer that has metastasized, or spread to other organs in the body, is frequently incurable, and chemotherapy and more recent targeted therapies might not be effective for all patients. Because of their invasive nature and high risk of consequences, biopsies to help establish the best treatments for this type of cancer are rarely performed. This is frequently a big obstacle to understanding and treating this illness.
The scientists found that the whole genome sequencing of ctDNA yields a wealth of data regarding the many metastases dispersed throughout the body. To acquire a deeper knowledge of the condition, the researchers used newly developed computer systems to identify the distinct genetic make-up of diverse cancer populations in the body.
“Metastatic cancers are complex and our understanding of them has been limited,” adds Dr. Wyatt. “Whereas traditional biopsies only provide a small snapshot of the disease, this new test is able to paint a more complete picture of metastases throughout the body, all from a simple and easy to perform blood test.”
The data, according to the researchers, can also be used to forecast which treatments will be successful or unsuccessful for each patient.
As “every cancer is unique and every patient responds differently to treatment, this new generation of ctDNA tests can help clinicians choose the treatment option that is most likely to benefit a patient,” adds Dr. Wyatt.
Treatment resistance insights
Even though there are now more ways to treat cancer than ever before, many of these treatments stop working after a while. As cancer cells accrue genetic alterations that make them less sensitive to a certain medicine or treatment, drug resistance can evolve over time.
The work by Dr. Wyatt and his group provides fresh insight into how this resistance manifests itself. By taking multiple samples of ctDNA over time, they were able to figure out how cancer changes in response to treatment. The results demonstrated how ctDNA profiling can be used to understand treatment resistance across multiple types of malignancies and showed new genetic underpinnings of resistance to the most popular medications for treating metastatic prostate cancer.
According to Dr. Wyatt, this technique can be used to study various cancer types to better understand how their tumors spread and eventually evade treatment. It will also aid in the development of the next generation of cancer treatments, which will more successfully combat resistant disease.
The researchers say that large clinical trials are now using this technology, which is minimally invasive, cheap, and easy to scale up. This includes cutting-edge precision oncology clinical trials being carried out at BC Cancer and the Vancouver Prostate Centre on Canadian cancer patients.
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