Category Archives: Biomarkers

Watching cancers evolve using ‘liquid biopsies’

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DNA fingerprint

Cancer’s evolving DNA can be detected using a blood test

Sometimes it feels like cancer research is progressing at a dizzying speed.

Just last year, we reported how Cancer Research UK scientists had reconstructed the evolution of a patient’s kidney tumour during treatment – one of many studies over the past few years illustrating cancer’s fearsome genetic complexity and adaptability.

This phenomenon, known as ‘intratumour heterogeneity’, led many to predict a long, hard slog to fully understand it – let alone get a handle on its implications for treatment.

One key concern was that patients would need to undergo a series of small operations (biopsies) to take repeated tissue samples to track how their cancer develops – and that this could be painful, costly and risky – especially for cancers deep in the body. And even then, because of the genetic variation within each patient’s cancer, there would be no guarantee that the biopsy results would represent an accurate picture.

Others also pointed out that such heterogeneity was a blow to the optimism around new-generation ‘targeted’ therapies, designed to treat cancer cells driven by individual mutations.

But recent discoveries have renewed this optimism. It turns out that tumours release DNA into the bloodstream, and that this seems to contain signals about what’s going on inside it. Consequently, there’s been a growing hope that analysing these DNA fingerprints could provide a quick, simple ‘liquid biopsy’ to track tumours’ progress.

And last month, researchers at our Cambridge Institute published compelling evidence that circulating DNA could indeed be used to take a snapshot of the DNA errors (mutations) in a patient’s breast cancer.

Today they’ve gone one step further proving, in a beautifully detailed paper in the journal Nature, that blood samples can be used to monitor genetic changes in a patient’s disease over time.

This has the potential to be a game-changer, and rapidly accelerate research into what makes cancers tick, in real patients, in timeframes that can impact on clinical decision making.

Let’s look at what they found.

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Blood test tracks breast cancer

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Blood test

A blood test could provide a simple way to monitor cancer

Cancer is a wily enemy. It mutates and spreads within the body and becomes resistant to treatment. Understanding and counteracting this tricksy behaviour is the greatest challenge for researchers and doctors, and is the key to bringing forward lasting cancer cures.

Thanks to advances in technology, we’re now starting to map out cancer’s underlying genetic landscape. In theory, if doctors knew exactly which gene faults were driving a patient’s cancer, they could give them the most appropriate targeted treatment.  

And as well as selecting the therapy with the best chances of working, it’s also important to know whether the disease is responding to treatment or not as fast as possible, so doctors can decide on the best course of action – for example, whether to continue with a particular drug or switch to a different one.

But there’s a problem with this approach. Monitoring how well a patient’s cancer is responding is not a simple job. At a minimum, it requires regular scans or other tests.  On top of this, analysing a tumour’s genes requires having a sample of it, usually taken as a biopsy with surgery, as well as access to tests that can provide meaningful results in a short timeframe. And if the cancer has spread to a multitude of locations in the body, it’s simply not possible to biopsy them all.

As an extra kicker, we now know that a single tumour can house cancer cells with a range of different gene faults – a characteristic that scientists refer to as “intra-tumoural heterogeneity”, but could also be described in rather more unpublishable words. And secondary cancers that have sprung up elsewhere in the body also have differences in their genetic makeup compared to the initial tumour.

The problems seem almost insurmountable – it’s a bit like trying to attack a shape-shifting army that we can’t properly see. But, as you might hope, research is coming to the rescue.

Building on work we talked about last year, scientists at our Cambridge Institute have made a significant step forward in developing a relatively simple genetic blood test that can monitor breast cancer as it progresses.

They’ve published their results in a paper in the New England Journal of Medicine, and although the title – “Analysis of circulating tumor DNA to monitor metastatic breast cancer” – may not set your heart racing, the contents are certainly inspiring for all of us hoping for progress in cancer research.
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MPs have a go at ‘citizen science’

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Shabana Mahmood MP

MPs were fascinated by CellSliderTM

We’ve been talking about our new ‘citizen science’ work a fair bit recently on this blog.

But it’s important to make sure that MPs are up to date with our latest projects. So yesterday we went to Parliament to tell them about it… and they loved it – after all, who wouldn’t want to “help beat cancer in five minutes?”

To recap briefly, last year, we launched Cell SliderTM, a citizen science project to help accelerate our groundbreaking research.

Taking just a few minutes and a few clicks of the mouse, Cell SliderTM is the first ever interactive website to turn real archive cancer data into a format that can be analysed by the public.

It presents real images of tumour samples in the form of a simple game of snap. Users are guided through a tutorial explaining which cells to analyse and which ones to ignore. By getting the public (yes, that includes politicians) to become ‘citizen scientists’, more samples will be analysed faster and more effectively, freeing up Cancer Research UK’s experts to carry out other cancer research.

To date, more than 650,000 images have already been analysed.

We asked MPs to have a go on cellslider.net and then urge their local communities to take part too. Here are a few photos, and some of their Tweets from the event:

  • Dr Julian Huppert, Liberal Democrat MP for Cambridge and a former research scientist

  • Shabana Mahmood, Shadow Minister for Universities and Science and Labour MP for Birmingham Ladywood

  • Nick de Bois, member of the All Party Parliamentary Group on Cancer and Conservative MP for Enfield North

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It was great to see some of Parliament’s cancer champions taking part, including John Baron MP, Chair of the All Party Parliamentary Group (APPG) on Cancer; shadow health minister Andrew Gwynne MP; James Arbuthnot MP, Chair of the APPG on Brain Tumours, Sir Bob Russell MP from the APPG on Smoking and Health, and Jim Shannon MP, the Democratic Unionist Party health spokesman.

We’re so pleased to have the support of MPs in raising awareness, as there’s still so much more we need to do to ensure no-one’s life is cut short by cancer.

By boosting our ability to analyse data quickly with the help of ‘citizen scientists’ – and by encouraging MPs to shout about it – our world-class research teams will be able to develop better ways to prevent, control and cure the disease and help save many more lives.

We’ll be doing some more exciting citizen science activities over the coming weeks and months so watch out for more info!

Laura

  • Laura Williams is a senior public affairs manager at Cancer Research UK

Stargazing to spot cancer

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Space and cancer

Astronomical techniques could help analyse cancer samples

Today our researchers announce the results of an exciting project bringing together two unlikely scientific bedfellows – astronomy and pathology.

Back in 2010, Dr Raza Ali and his team at our Cancer Research UK Cambridge Institute joined forces with the University of Cambridge’s Institute of Astronomy to focus their techniques for scanning the night sky onto the challenge of spotting rogue cancer cells.

Spotting key differences between tumour samples holds the key to understanding why some cancers progress more quickly than others, and why patients respond differently to treatments. But despite increased automation in many areas, this kind of analysis still largely relies on expert pathologists looking down the microscope at tumour samples and scoring the presence of particular protein molecules.

Regular readers of the blog will know that Cancer Research UK recently launched the world’s first citizen science cancer project Cell Slider to help break this data bottleneck. But for some time, scientists have also been looking at ways to automate the process and train machines to do the hard work. Today, our scientists published their latest progress towards this goal.

Writing in the British Journal of Cancer, Dr Ali and his team show how the automated techniques the astronomers use to analyse deep sky images can also detect subtle differences in protein levels between healthy and cancerous breast cells.

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Tissue study turns tables on prostate cancer

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A scientist in the lab

A new study has lifted the lid on advanced prostate cancer

As we heard yesterday, a man’s lifetime risk of developing cancer is set to climb to one in two by 2027, and one of the biggest reasons is an increase in prostate cancer rates.

But research is bringing hope that more and more men will survive this disease and, based on recent progress, we have every reason to be optimistic.

Over the past couple of years we’ve made significant strides in prostate cancer research and treatment. This year the drug abiraterone (Zytiga), which our researchers helped to develop, was approved across the UK for men with advanced prostate cancer. And other important new drugs have emerged recently from research around the world and are showing promise in clinical trials, including enzalutamide (Xtandi), cabazitaxel (Jevtana) and radium-223 (Alpharadin).

Our researchers labs around the UK are also making progress in prostate cancer (such as in drug development, targeting cancer’s energy supply, finding gene faults that drive the disease and  control how fast it grows and developing new types of therapy) and in the clinic (for example in hormone therapy, radiotherapy and more personalised treatment) as well as improving screening. And through our role in the International Genome Consortium prostate cancer project, we’re using the latest technology to understand prostate cancer’s genetic secrets and drive forward future advances.

It’s clear that momentum is gathering and things are moving faster than ever before. And now an important new study from scientists at our Cambridge Research Institute, published in the journal Cancer Cell, reveals a completely new gene network that can carry on driving advanced prostate cancer after patients become resistant to hormone treatment.

The findings paint a new picture of the processes that drive prostate cancer, and shed light on how we might be able to tackle it more effectively in the future. To find out more, watch this brilliant little video featuring lead researcher Naomi Sharma and some Lego:

Let’s look in a bit more detail at what the Cambridge team did, and how their discovery could help us beat prostate cancer sooner.

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The slow dawn of the age of targeted therapies

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As NICE approves two new melanoma drugs, we look at how far we’ve come in developing ‘personalised’ cancer care.

This morning, the National Institute of Health and Clinical Excellence (NICE) reversed its original, preliminary decisions over two cutting-edge ‘targeted’ melanoma treatments – ipilimumab and vemurafenib.

Both drugs will now be available on the NHS to suitable patients throughout England, Wales and Northern Ireland.

(Scotland has its own drug approval body, the Scottish Medicines Consortium, which has so far given a ‘no’ to both drugs)

This is great news. It turns out that the manufacturers of both drugs have now provided sufficient information, and set up suitable discount schemes, to allow the drugs to be considered value for money on the NHS – essential in these straitened times. We hope they’ll resubmit this information to the Scottish regulators as soon as possible.

But how does this fit into the bigger picture of targeted therapies and personalised medicine?

We thought that in the light of this news, and of some recent critical pieces in the mainstream media, we’d take a look at the state-of-play regarding what many consider to be a new ‘era’ of cancer treatment.

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Help us beat cancer – with just a few clicks of your mouse

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Help beat cancer with a few clicks of your mouse

Imagine a world where millions of people are helping to find ways to control and cure cancer, from the comfort of their own homes.

Imagine these people taking part in a project which might – one day – become a candidate for the Nobel Prize in medicine.

That’s the vision behind our new ‘citizen science’ project. Launching today, http://www.clicktocure.net/ allows the general public to directly take part in our life-saving work, by actually increasing the pace of cancer research.

So, what’s it all about?

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