What if, 5 to 10 years from now, a simple blood test could not only be used to detect cancer but even tell your doctor which treatment would work best for you? This could be the result of a research study which is being supported by Paul Strickland Scanner Centre.
Using the numbers of circulating tumour cells and/or white blood cells, or the expression or activation of certain genetic information in these cells, the CICATRIx study (see further down) aims to see whether it’s possible to detect what is likely to happen to a patient’s cancer earlier, and more accurately, than currently.
The study focusses on advanced rectal cancer, a type of cancer affecting the bottom of the bowel.
“The research pulls together three great institutions – Mount Vernon Cancer Centre, where lots of patients are being treated, Paul Strickland Scanner Centre (where patients are being scanned), and Brunel University – who do the blood work for the study,” said Dr Tom Smith, senior Clinical Research Fellow at Mount Vernon. The funding for Dr Smith’s post is jointly funded by Paul Strickland Scanner Centre and Mount Vernon Cancer Centre.
The link to imaging
“The research is very much about linking the blood work to the imaging and trying to see what the relationship is between those two.
Some of the newer scanning techniques and sequences offered by Paul Strickland Scanner Centre give us more information about what’s happening to the cancer during a particular treatment. We hope this will allow us to better select which patients have had a good response to treatment – in particular where the cancer has disappeared – allowing us to better select which patients might benefit from which treatment in the future. Alongside that, we’re also doing some blood work, so these patients are having blood tests during their treatment.
“A lot of these patients have their scans done at their local hospital at the moment, however the scans and the scanning sequences aren’t always done to the standards that the research team need. We’re looking to recruit patients who are having their treatment here, in order to to get them to Paul Strickland Scanner Centre for the high quality, contrast-enhanced MRI scans that we need.
“The accuracy and detail we can get from Paul Strickland Scanner Centre [images] can give doctors more information than you can get on a standard scan.
“We’re hoping to recruit 20-30 patients with advanced rectal cancer onto the study over the next 12 months, and when we’ve recruited enough we’ll be able to go into the data analysis phase. On average patients are in their 60s, although we have patients from their early 30s up to their late 80s that are being treated and would be suitable for the study.”
What is CICATRIX?
In some cancers, blood samples can show what response a patient may be having to their treatment. This can be achieved through looking at the levels of certain proteins in the blood that are produced in excess in patients with advanced cancer.
The level of the protein is a “marker” for the number of active cancer cells in your body. CA125 is one example of this type of “marker”; Prostate Specific Antigen (PSA) is another, more commonly known, one.
Recently, techniques have been developed that allow the examination of the actual circulating cancer or tumour cells (CTCs), or sometimes just “free” DNA in the blood. The study explores the feasibility of examining blood for such circulating cancer cells and DNA using a new technique. In addition to this, it is planned to examine the CTCs for the expression of certain genes in order to evaluate if this could determine treatment outcomes earlier.
There is some evidence that immunity might be suppressed by cancer, and restoring this might allow a patient’s cancer to be controlled in the longer term.
Examining the white blood cells in cancer patients could help explore this concept further, as it’s possible that the white cells change in response to cancer and help the cancer cells to spread and grow.
These changes may be altered by treatments. If these changes are predictable, this may help doctors identify new ways to treat or control cancer in the future.