This document discusses the potential for a blood test to enable early cancer detection. It notes that cancer incidence is predicted to double worldwide by 2030 while survival rates for many cancers have changed little in recent decades. Early detection through screening has been shown to significantly reduce mortality for some cancers like breast, lung, and colon cancer. The document proposes a blood test that could detect autoantibodies produced in response to cancer cells, providing improved sensitivity and specificity over other screening methods. It summarizes pilot studies showing this approach can detect colorectal, lung, and breast cancers at early stages with promising sensitivity and specificity. The goal is to make early cancer detection more accessible and improve clinical outcomes through increased survival rates and reduced treatment costs.
The Molecular Analysis on Circulating Tumor Cells to Determine Prognostic and...QIAGEN
Circulating tumor cells (CTCs) is an emerging source used molecular cancer diagnostics. Through expression profiling of CTCs, it allows a deeper understanding about which metabolic pathways enable tumor cells to survive in the circulation, how they become resistant to a drug regimen, how they transform and adapt and, finally, which cellular markers should targeted for future therapies.
This webinar will introduce the AdnaTest CTC detection platform which has been proven in several clinical trials to provide prognostic and predictive information in breast, ovarian and prostate cancer. The platform by itself is still open for research and allows access to any potential target of interest. Join us to learn more about this novel platform, its technology and applications in liquid biopsy.
The Molecular Analysis on Circulating Tumor Cells to Determine Prognostic and...QIAGEN
Circulating tumor cells (CTCs) is an emerging source used molecular cancer diagnostics. Through expression profiling of CTCs, it allows a deeper understanding about which metabolic pathways enable tumor cells to survive in the circulation, how they become resistant to a drug regimen, how they transform and adapt and, finally, which cellular markers should targeted for future therapies.
This webinar will introduce the AdnaTest CTC detection platform which has been proven in several clinical trials to provide prognostic and predictive information in breast, ovarian and prostate cancer. The platform by itself is still open for research and allows access to any potential target of interest. Join us to learn more about this novel platform, its technology and applications in liquid biopsy.
maintrac liquid biopsy on circulating epithelial tumor cells Peter Pachmann
maintrac liquid biopsy on circulating epithelial tumor cells. Microscope based semi-automated discrimination of cancer cells, effectiveness testing of cancer drugs (before treatment) andtherapy monitoring
2017 ASCO RECAP: The Latest in Colorectal Cancer Research #CRCWebinarFight Colorectal Cancer
Don’t miss our recap webinar from the American Society of Clinical Oncology Annual Conference (ASCO) where we discuss the latest research and treatments for colorectal cancer patients presented during the conference.
Dr. Dustin Deming, a medical oncologist and Fight CRC Medical Advisory Board Member will guide us through his findings. Dr. Deming brings a unique perspective as a researcher, oncologist and colorectal cancer survivor. In this webinar we will dive into the research and explain what it means for those living with colorectal cancer.
Richard Kim, MD, and Karon Martyn, MSN, ANP-BC, AOCNP, prepared useful Practice Aids pertaining to mCRC for this CME/MOC/CE activity titled "A Team Approach to Tackling the Complexities in Later Lines of Therapy for Metastatic Colorectal Cancer." For the full presentation, monograph, complete CME/MOC/CE information, and to apply for credit, please visit us at http://bit.ly/2IpIBz4. CME/MOC/CE credit will be available until May 29, 2019.
Purpose: An inherited mutation in KRAS (LCS6-variant or rs61764370) results in altered control of the KRAS oncogene. We studied this biomarker’s correlation to anti-EGFR monoclonal antibody (mAb) therapy
response in patients with metastatic colorectal cancer.
Experimental Design: LCS6-variant and KRAS/BRAF mutational status was determined in 512 patients
with metastatic colorectal cancer treated with salvage anti-EGFR mAb therapy, and findings correlated with
outcome. Reporters were tested in colon cancer cell lines to evaluate the differential response of the LCS6-
variant allele to therapy exposure.
Results: In this study, 21.2% (109 of 512) of patients with metastatic colorectal cancer had the LCS6-
variant (TG/GG), which was found twice as frequently in the BRAF-mutated versus the wild-type (WT) group
(P = 0.03). LCS6-variant patients had significantly longer progression- free survival (PFS) with anti-EGFR
mAb monotherapy treatment in the whole cohort (16.85 vs. 7.85 weeks; P = 0.019) and in the double WT
(KRAS and BRAF) patient population (18 vs. 10.4 weeks; P = 0.039). Combination therapy (mAbs plus
chemotherapy) led to improved PFS and overall survival (OS) for nonvariant patients, and brought their
outcome to levels comparable with LCS6-variant patients receiving anti-EGFR mAb monotherapy. Combination
therapy did not lead to improved PFS or OS for LCS6-variant patients. Cell line studies confirmed a
unique response of the LCS6-variant allele to both anti-EGFR mAb monotherapy and chemotherapy.
Conclusions: LCS6-variant patients with metastatic colorectal cancer have an excellent response to anti-EGFR
mAb monotherapy, without any benefit from the addition of chemotherapy. These findings further confirm
the importance of thismutation as a biomarker of anti-EGFR mAb response in patients with metastatic colorectal cancer, and warrant further prospective confirmation.
Biomarkers and biomarker testing are changing the way some colorectal cancer is treated and knowing your biomarkers can help your doctors identify your best treatment options and help you in making well informed decisions about how your cancer will be treated allowing you to be your own best advocate.
Join in on this informative webinar with guest Dr. Christopher Lieu from the University of Colorado Cancer Center, as he discusses everything you need to know about biomarkers.
maintrac liquid biopsy on circulating epithelial tumor cells Peter Pachmann
maintrac liquid biopsy on circulating epithelial tumor cells. Microscope based semi-automated discrimination of cancer cells, effectiveness testing of cancer drugs (before treatment) andtherapy monitoring
2017 ASCO RECAP: The Latest in Colorectal Cancer Research #CRCWebinarFight Colorectal Cancer
Don’t miss our recap webinar from the American Society of Clinical Oncology Annual Conference (ASCO) where we discuss the latest research and treatments for colorectal cancer patients presented during the conference.
Dr. Dustin Deming, a medical oncologist and Fight CRC Medical Advisory Board Member will guide us through his findings. Dr. Deming brings a unique perspective as a researcher, oncologist and colorectal cancer survivor. In this webinar we will dive into the research and explain what it means for those living with colorectal cancer.
Richard Kim, MD, and Karon Martyn, MSN, ANP-BC, AOCNP, prepared useful Practice Aids pertaining to mCRC for this CME/MOC/CE activity titled "A Team Approach to Tackling the Complexities in Later Lines of Therapy for Metastatic Colorectal Cancer." For the full presentation, monograph, complete CME/MOC/CE information, and to apply for credit, please visit us at http://bit.ly/2IpIBz4. CME/MOC/CE credit will be available until May 29, 2019.
Purpose: An inherited mutation in KRAS (LCS6-variant or rs61764370) results in altered control of the KRAS oncogene. We studied this biomarker’s correlation to anti-EGFR monoclonal antibody (mAb) therapy
response in patients with metastatic colorectal cancer.
Experimental Design: LCS6-variant and KRAS/BRAF mutational status was determined in 512 patients
with metastatic colorectal cancer treated with salvage anti-EGFR mAb therapy, and findings correlated with
outcome. Reporters were tested in colon cancer cell lines to evaluate the differential response of the LCS6-
variant allele to therapy exposure.
Results: In this study, 21.2% (109 of 512) of patients with metastatic colorectal cancer had the LCS6-
variant (TG/GG), which was found twice as frequently in the BRAF-mutated versus the wild-type (WT) group
(P = 0.03). LCS6-variant patients had significantly longer progression- free survival (PFS) with anti-EGFR
mAb monotherapy treatment in the whole cohort (16.85 vs. 7.85 weeks; P = 0.019) and in the double WT
(KRAS and BRAF) patient population (18 vs. 10.4 weeks; P = 0.039). Combination therapy (mAbs plus
chemotherapy) led to improved PFS and overall survival (OS) for nonvariant patients, and brought their
outcome to levels comparable with LCS6-variant patients receiving anti-EGFR mAb monotherapy. Combination
therapy did not lead to improved PFS or OS for LCS6-variant patients. Cell line studies confirmed a
unique response of the LCS6-variant allele to both anti-EGFR mAb monotherapy and chemotherapy.
Conclusions: LCS6-variant patients with metastatic colorectal cancer have an excellent response to anti-EGFR
mAb monotherapy, without any benefit from the addition of chemotherapy. These findings further confirm
the importance of thismutation as a biomarker of anti-EGFR mAb response in patients with metastatic colorectal cancer, and warrant further prospective confirmation.
Biomarkers and biomarker testing are changing the way some colorectal cancer is treated and knowing your biomarkers can help your doctors identify your best treatment options and help you in making well informed decisions about how your cancer will be treated allowing you to be your own best advocate.
Join in on this informative webinar with guest Dr. Christopher Lieu from the University of Colorado Cancer Center, as he discusses everything you need to know about biomarkers.
La Monitorización es una de las etapas más importantes de
cualquier proyecto de captura y almacenamiento de CO2 (CAC).
En esta presentación se verá cuales son los principales objetivos de la monitorización a lo largo de un proyecto de captura y almacenamiento de CO2
Robert P. Edwards, MD, Chair of OB/GYN/RS, Co-Director of Women's Cancer Program at University of Pittsburgh, offers information about the current state of immunotherapy for recurrent ovarian cancer patients.
Clinical and experimental studies regarding the expression and diagnostic val...Enrique Moreno Gonzalez
Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) is a multifunctional Ig-like cell adhesion molecule that has a wide range of biological functions. According to previous reports, serum CEACAM1 is dysregulated in different malignant tumours and associated with tumour progression. However, the serum CEACAM1 expression in nonsmall-cell lung carcinomas (NSCLC) is unclear. The different expression ratio of CEACAM1-S and CEACAM1-L isoform has seldom been investigated in NSCLC. This research is intended to study the serum CEACAM1 and the ratio of CEACAM1-S/L isoforms in NSCLC.
Advances in risk assessment, differential diagnosis between aggressive and non-aggressive tumors, and the development of novel/optimized treatment for advanced disease are discussed.
This slide deck is made available for patients/caregivers. It is not a substitute for seeking medical help. Please check original sources listed in the deck and consult your physician for the latest information and advice.
The Presence and Persistence of Resistant and Stem Cell-Like Tumor Cells as a...QIAGEN
Epithelial ovarian cancer is the fifth leading cause of cancer-related deaths of women in the United States and Europe and ranks as the second most common type of gynecological malignancy. Most cases are diagnosed in advanced stages and although the response rates to platinum-based chemotherapy are high, the majority of patients nevertheless have poor survival rates. Although the reasons for these poor outcomes are likely to be multifactorial, one particular area of interest has recently focused on hematogenous tumor cell dissemination that has been shown to originate from disseminated tumor cells (DTCs) in the bone marrow (BM) and circulating tumor cells (CTCs) in the blood. Here, we demonstrate that the negative prognostic impact of CTCs and DTCs arise from specific cellular phenotypes and are associated with platinum-resistance and stem cell-associated proteins.
Cancer screening may discover many dormant, regressing, or slowly progressing tumors that would not have affected the screened individuals. Such findings with there therapies are obviously harmful. This lecture is highly based on the book "over diagnosed" by H. Gilbert Welch and was presented in 2013 to KFSH-Dammam physicians
Bladder Cancer Diagnostic-Initial Team ProjectSagar Desai
A mini-project to find biomarkers for bladder cancer diagnosis. We narrowed down our list of viable candidates down to three that could be used in combination to provide sensitivity and specificity values greater than 94%. Furthermore, we calculated long-term monitoring and payor costs as well as potential profit.
Antigen Microarray Technology for Early detection of Solid Cancers.
1. Early Cancer Detection
Dr O H Negm
ola.negm@nottingham.ac.uk
01.07.2016 Nottingham Pathology 20161
CEAC: Centre of Excellence for Autoimmunity in Cancer
3. • Within a 30 year period (2000 – 2030), cancer is predicted to double in
incidence worldwide, with a concurrent doubling in number of deaths/year.
01.07.2016 Nottingham Pathology 20163
• For many types of cancer the outlook has changed little in the last 30
years.
– Lung cancer – <10% have surgery in UK and 5%-10% alive at 5 years
– Pancreatic cancer – 1% alive at 5 year
• Most people are diagnosed only when there is a late ‘presentation’ of the
cancer; impaired survival, major forms of therapy, major operation,
chemotherapy and radiotherapy.
4. Early detection and treatment has been shown to
significantly reduce mortality:
Randomised trials (‘Level 1’ evidence)
• Breast Cancer - Mammography (50-74yrs)
– 23% reduction in deaths from breast cancer
– [NB: only ~1/3rd of BCs occur between 50-74]
• Lung Cancer – CT scans (55-74yrs, >30 pys)
– 20% reduction in deaths from lung cancer
– [NB: Only ~1/3rd LCs occur in NLST trial]
• Colon Cancer – faecal occult blood test + colonoscopy (>50yrs)
– 16% reduction in deaths from colon cancer
– [NB: Only ~1/3rd individuals accept colon screening]
01.07.2016 Nottingham Pathology 20164
5. Our solution is to provide a blood test that will:
• Improve public acceptability.
• Provide improved sensitivity & specificity compared to other screening
methods.
• This will significantly improve clinical outcomes (improved survival
rates) and cost-effectiveness.
01.07.2016 Nottingham Pathology 20165
7. 01.07.2016 Nottingham Pathology 20167
q The immune system, which protects us
from microbes, also mounts a response to
very small amounts of aberrant protein
overproduced and released by cancer
cells within a tumour.
q This response includes the generation of
autoantibodies (AAbs) to these tumour-
associated molecules/antigens (TAAs).
q Autoantibodies directed against TAAs
were shown to be relevant tumour
biomarkers and can be detected up to 5
years before the tumour is overt clinically.
Immune response to cancer cells
10. 01.07.2016 Nottingham Pathology 201610
q Prof Robertson and his team in collaboration
with oncimmune have already developed a
blood test which has moved from the 'bench
to the bedside' enabling the early detection
of lung cancer. This test is called Early CDT-
Lung.
q The test is currently in clinical use and has
already shown that within high risk
populations that cancers can be detected
early whilst they are still treatable with the
potential for increased patient survival and
indeed in some cases cure.
Stage 1A Lung Cancer – curable!
14. Background
• Colorectal cancer (CRC) is the 2nd highest cause of cancer mortality in the
Western world.
• Key to better survival is early diagnosis (>90% survival if detected early).
• Current early diagnostic methods (ie Faecal sampling) have low takeup
(57%:Uk, 34% EU). Alternative investigations are invasive (ie
sigmoidoscopy, colonoscopy) and have equally poor patient acceptability.
01.07.2016 Nottingham Pathology 201614
15. 01.07.2016 Nottingham Pathology 2016
Antigen-based protein microarrays:
q TAAs are arrayed (spotted) as a regular
pattern (a microarray) onto an activated surface. A single array can
have multiple TAAs, each at separate location.
q A 5x5mm array can accommodate up to
150+ individual features.
q Immobilized TAAs are exposed to a
patient serum sample.
q Autoantibodies binding to any of the
TAAs can be detected fluorescently and
measured
16. Antigen-based protein microarrays
Advantages including:
• High throughput, much increased capacity for multiplexing detection
of a range of specific AABs.
• Reduced requirements for TAAs, serum and reagents;
• Increased assay robustness; better sensitivity and specificity than
that achievable by ELISA-based assays.
01.07.2016 Nottingham Pathology 201616
17. Serum samples: sera from 3 different cohorts; 200 sera from Pittsburgh,
USA (100 CRC and 100 controls), 42 sera (21 CRC and 21 matched controls)
from New York, USA, and 20 sera from Dundee, UK (10 CRC and 10 controls)
were tested.
A panel of multiple tumour-associated antigens (TAAs) using an
optimised multiplex microarray system. Tumour-associated antigen selection:
a panel of 32 TAAs (non-glycosylated recombinant proteins expressed in
E.coli) were included: P53, SOX2, NY-ESO-1, GBU, MAGE A4, HuD, AFP,
Gankyrin, GRP78, HCC1, HDGF, H-Ras1, IMP, p62, RalA, MUC1, CEA, Annexin
A1, rhUteroglobulin (CCSP1), K-Ras, APC1, APC2 blocking peptide, SDCCAG8
(NY-CO-8), TDRD6 (NY-CO-45), vWFA2 (CCSP2), ErbB2, RAF1, SCGB1A1,
CA19-9, UTP14A (NY-CO-16), K-RAS-Q61H and APC-N.
Pilot study
01.07.2016 Nottingham Pathology 201617
19. 1- Quality assessment of the antigens
Antigen Quality
A representative analysis of a selection of TAAs by Western blot (WB) and Silver
stain.
A)
Printing New Antigens
Evaluation of the optimal concentration to print the new antigens
ERBB2
100 ug
50 ug
25 ug
B)
01.07.2016
Nottingham Pathology 201619
20. 2- Internal QC measures on Microarray
Serial dilution of purified human IgG to
verify function of the detection system
and provide a standard curve of human
IgG against which AAb responses could
be calibrated.
Nottingham Pathology 2016
22. 4- Sensitivity and Specificity of the assay.
Antigen/Panel Sensitivity (%) Specificity
(%)
AFP 27 95
P53 26 95
K Ras 27 96
NY-CO-16 41 95
RAF1 18 95
Annexin 29 94
A panel of the 6
TAAs
61.1% 80.9%
Sensitivity and specificity of individual TAAs and panels of TAAs were calculated to establish the best
combinations of this test set of TAAs that would provide good discrimination between cancer-positive
and normal serum samples.
Results
23. 5- Sensitivity of CRC sample set by stage (A) and site (B).
The sensitivity is not a stage dependent. The data also show no difference in AAb detection by CRC
location (76% sensitivity for left side CRCs and 72% for right side CRCs).
24. 01.07.2016
Nottingham Pathology 201624
Human blood autoantibodies in the detection of colorectal cancer
Ola H Negm, Mohamed R Hamed, Robert E Schoen, Richard L Whelan, Robert J Steele, John Scholefield, Elizabeth M Dilnot, Shantha
Kumara, John FR Robertson, Herbert F Sewell.
PLOS one- June 2016
26. 01.07.2016 Nottingham Pathology 201626
Pilot Study for Early Detection of breast cancer
q The preliminary data confirmed that BC also induces autoantibodies (AAbs) against
the small number of specific tumour associated antigens (TAAs) used in this pilot
study.
q These pilot results showed positive autoantibody signal was detectable across all age
ranges (ie <50yrs, 50-70 years and >70 years) and that the positive tests were as
frequent in early stage cancer (stages 1 & 2) as in late stage disease. The results
showed that 90% of positive samples for the autoantibody test were hormone
receptor positive (HR +ve).
q Initial proof of principle studies have been run to confirm our hypothesis.
q Breast cancer serum samples included 300 invasive BC, (approx. 50% being stage
1/2) and 300 age and gender matched controls.
27. Plots of reactivity to four individual TAAs: BRCA1 (A), EPCAM (B), MUC1 (C) and MAGE A4 (D) probed with breast cancer (BC)
and normal control (Con) sera. Each graph shows side-by-side comparisons of AAb responses to the TAA antigens for clinically
confirmed BC (white circles) and control (grey circles).
Reactivity of selected TAAs to sera from breast cancer patients and normal controls
28. Proven preventative treatments:
potential to prevent ~35%
of all breast cancer cases
01.07.2016 Nottingham Pathology 201628
70%
of all breast cancers
are stimulated to
grow by estrogen
50%
Prevented by drugs
like tamoxifen
~35%
of cases could be
prevented
X =
Blood test to identify
at early stage
29. What will be achieved
Early detection of all types of solid cancers will mean:
• More people have a greater chance of survival
• Improved survival rates and life expectancy
• Less aggressive treatments
• Less money spent on treatment.
• Worldwide impact– applicable to low & medium income countries too
Within 5 years
• Can get 3 common cancers (eg breast, colon & primary liver cancer),
through to market and available for clinical use in the UK.
• Tests for other cancers would be at various stages of development.
01.07.2016 Nottingham Pathology 201629