Four years ago, researchers from Crick and UCL’s CRUKTRACERx team, along with industry collaborator Natera, used a circulating fragment of tumor DNA (ctDNA) in the blood of lung cancer patients to predict whether or not they had cancer. Was developed. After surgery, you’ll be back even before you can see it on the scan.And last week, a blood test based on personalized tumor information Signatella Breakthrough clinical trials have proven effective in defining patients who will benefit from immunotherapy after surgery. Charles Swanton, Head of Cancer Evolution and Genome Instability Laboratory at Crick and UCL and Principal Clinician at Cancer Research UK, explains how this technology has evolved from ideas to potentially life-saving clinical trials.
Caring for cancer patients is very rewarding. Amazing progress has been made in recent years, with new tests and treatments. disease For more people. However, important challenges remain.
Tumors evolve over time, adapt to their surroundings, become refractory to treatment, and spread to other parts of the body. We and others believe that detecting an early recurrence of the disease will reduce the burden of the disease and increase the likelihood that treatment will be effective.
This launched TRACERx, a Cancer Research UK-funded study to investigate how genetic changes and diversity within tumors affect the course of the disease and to track the evolution of lung cancer in real time. The reason is. We have tracked hundreds of patients, from diagnosis to recurrence of the disease or cure after surgery, and tracked and analyzed how their cancer progressed.
To One of our studies since 2017, We have shown that a patchwork of genetic defects defined by gene sequencing of a patient’s lung tumor tissue can be used as a fingerprint of cancer. This fingerprint has shown that it may help identify the patient’s cancer debris after surgery. Simple blood test.. In some cases, regular follow-up scans could detect recurrent cancer months before the doctor caring for the patient found the same cancer.
The ctDNA test is based on patient-specific genetic mutations that are present in all parts of the tumor. By amplifying these unique markers, minimal residual disease can be easily detected. With a needle in a haystack, it’s almost impossible to find.
And last week there was news that every researcher wanted. Verification of this breakthrough technology has helped improve patient outcomes.
At a landmark Clinical trial Researchers led by Dr. Thomas Powles of the Barts Cancer Institute conducted the Signateract DNA test on more than 500 patients who had surgery to remove a tumor in the bladder or urinary system. Patients were randomized to receive monitoring or additional treatment with the immunotherapeutic drug atezolizumab. Patients with ctDNA positive improved overall survival when treated with atezolizumab, but not in patients without blood ctDNA.
This means that this test can be used to accurately identify patients who are most likely to benefit from additional treatment and, more importantly, are more likely to survive longer. This not only increases the number of people who survive their cancer, but also avoids the side effects associated with unnecessary treatment of others.
This is not the only possible benefit. These types of tests can completely change the way patients are treated after surgery. Traditionally, pathological information about the stage of the tumor is used to provide additional treatment, such as postoperative chemotherapy, to eradicate residual tumor cells that may spread throughout the day and minimize the risk of recurrence. I will guide you whether to suppress it. But now there is real potential that treatments can only be refined and guided by molecular tests like these and then offered to patients who really benefit from it.
I could see the end of the anxious wait that patients faced between follow-up scans and wondered if their treatment was successful or if the cancer had recurred.You can also use this with further verification of different types of cancer test The scan monitors the response to treatment in the absence of disease and modifies the tack with the earliest signs of drug resistance.
This is not possible without the basis of biological research. A basic understanding of tumor genetics and evolution has led to more sophisticated individualized examinations and treatments.There is no doubt that we will see it in the not too distant future cancer Treatment plans that are notified through individualized genetic testing and regular monitoring of tumor DNA in the blood.
Francis Crick Institute
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How Blood Tests Are Changing Cancer Treatment
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