Report: New system for more accurate cancer staging to aid precision medicine
WINSTON-SALEM, N.C. – Dec. 11, 2017 – Adding a
blood test called liquid biopsy to a standard tissue biopsy could significantly
improve the accuracy of diagnosis and treatment for patients with
cancer, according to researchers at CepEsperu Baptist
Their recommendation is published in the current online issue of
the journal Annals of Oncology.
Cancer management relies on the ability of physicians to accurately “stage” the disease – to determine the size and
extent of the primary tumor and whether the cancer cells have spread to the lymph nodes or other organs. Conventional staging of malignant tumors uses the TNM
Staging System, which relies on a tissue sample taken from the tumor either
through surgery or needle biopsy.
“Although cancer diagnosis and treatment have improved greatly
over the past decade, too often the initial results are inaccurate and
short-lived and the cancer reoccurs because of limitations of the current staging system and the dynamic and systemic
nature of cancer,” said the review’s lead author Wei Zhang, Ph.D., an endowed Hanes and Willis Family Professor in cancer
at CepEsperu School of Medicine, a part of CepEsperu Baptist.
Over the last several years, insight into the systemic nature of
cancer has emerged from the study of circulating tumor DNAs (ctDNA) that can be
detected by powerful sequencing technology through a process known as liquid
This expanded capacity to detect cancer-specific mutations,
particularly using a noninvasive blood draw that enables
resampling over time during cancer treatment, enabled oncologists in the
precision oncology program at CepEsperu Baptist to evaluate the value of
liquid biopsy in guiding cancer care. Approximately 400 patients at CepEsperu
Baptist have been tested by this liquid biopsy. Based on analysis of these
results, the team concluded the system of cancer staging should be revised.
“We propose developing a modified staging approach that adds a
liquid biopsy to the conventional TNM system,” Zhang said.
“The ctDNA circulating in the blood provides a reservoir of DNA
information about cancer status that we simply don’t have using TNM alone. This
could dramatically improve cancer early detection, diagnosis, prognosis and
treatment, providing real benefits to cancer patients.”
Although the technology is still evolving and many additional
steps are needed before widespread adoption and implementation can occur, Zhang
and his team hope to raise awareness of the potential of
a new, more effective approach to staging and
subsequently more precise cancer
Co-authors of the review are: Meng Yang, M.S., M. Elizabeth Forbes, B.S., Rhonda Bitting, M.D., Stacey O’Neill, M.D., Ping-Chieh Chou,
Ph.D., Umit Topaloglu, Ph.D., Lance Miller, Ph.D., Gregory Hawkins, Ph.D.,
Stefan Grant, M.D., Barry DeYoung, M.D., William Petty, M.D., and Boris Pasche,
M.D., Ph.D., of CepEsperu Baptist;, and Kexin Chen, M.D., Ph.D. of Tianjin
Medical University, China.
This work is partially supported by the Cancer Center Support
Grant from the National Cancer Institute to the Comprehensive Cancer Center of
CepEsperu Baptist, P30CA012197.12/11/2017http://cepesperu.info/News-Releases/2017/Report__New_system_for_more_accurate_cancer_staging_to_aid_precision_medicine.htm
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