Treatment selection and monitoring of treatment response
Using liquid biopsy to match the right patients to the right trials and develop new treatments.
Cancer precision medicine has the potential to improve outcomes for patients in Greater Manchester and beyond, but significant challenges must be overcome before this approach can become part of everyday clinical practice.
- Develop and apply simple blood tests (liquid biopsy) to identify patients who are most likely to benefit from an early clinical trial, working in collaboration with Manchester’s NIHR/CRUK Experimental Cancer Medicine Centre (ECMC), the highest recruiter of patients into early clinical trials across the UK network.
Circulating tumour DNA (ctDNA) is shed via tumour cell death into the bloodstream where it can be sampled and analysed. We have recently established an optimised ctDNA assay/test (comprising 652 gene panel) with a bespoke bioinformatics pipeline for data analysis. This assay demonstrated high concordance with tumour profiling in a pilot study of 100 patients entering our Phase I unit. DNA sequencing data from the blood test and the tumour are discussed biweekly at our multidisciplinary molecular tumour board.
We will now implement ctDNA analysis routinely and this liquid biopsy will contribute to clinical decision making, selecting the most appropriate available Phase I trial for our patients.
By monitoring their response through serial blood tests, we will also be able to better anticipate resistance and more quickly change our approach if the treatment stops working.
- Expand our existing laboratory protocols for monitoring patient response to treatment and testing patient-derived cell cultures (samples) to inform the development of new therapies
We are developing protocols for testing patient tumour-derived cell cultures (biopsy, ascites, circulating tumour cells) to validate treatment response in real time and to support studies of likely emergent drug resistance mechanisms in a laboratory setting.
The next step is to extend this research on melanoma, breast, lung and ovarian cancers, to include additional cancer types and new culture protocols (organoids, cancer stem cell spheroids, co-cultures embracing tumour microenvironments).
This work will benefit from The University of Manchester’s biomarker expertise.