The test could be performed at a GP practice and would help doctors prioritise patients with widespread and later stage cancer.
By Amy Barrett \ Science focus
Cancer researchers have developed a new blood test that could improve diagnosis and treatment for patients. The test is the first to be able to detect not only the presence of cancer but also the spread of the disease around the body, which is often categorised in cancer stages.
Currently, patients who are diagnosed with cancer have to undergo imaging and testing before doctors can tell if it has spread to any other part of the body. A cancer that has spread is called metastatic cancer.
This knowledge then informs treatment, as patients with tumours in a single area are offered a local treatment, like surgery, while those with cancer that has spread would need whole-body treatments like chemotherapy or hormone therapy.
Now, a new blood test has successfully identified metastatic cancer in 94 per cent of the 300 patients sampled.
The test, developed by researchers at University of Oxford, uses a new technique called NMR metabolomics, which identifies the presence of biomarkers in the blood, called metabolites. These are small chemicals that our body naturally produces.
“Metabolites are any small molecules in blood such as glucose, lactic acid, or amino acids,” explained oncologist Dr James Larkin, who worked on the study. “The exact pattern of metabolites present in your blood varies depending on what is going on in your body, something which is influenced by diseases like cancer.”
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Crucially, the test can tell whether a person’s cancer has spread, they will have a certain metabolomic profile that is different from a patient with localised cancer, or from someone without cancer.
The NMR metabolomics technology could open up a wide range of new avenues for disease detection, not just in cancer but in other conditions too, said Larkin.
“We are only now starting to understand how metabolites produced by tumours can be used as biomarkers to accurately detect cancer,” he said. “We have already demonstrated that this technology can successfully identify if patients with multiple sclerosis are progressing to the later stages of disease, even before trained clinicians could tell.
“It is very exciting that the same technology is now showing lots of promise across a wide range of diseases, including those often confused for multiple sclerosis, such as neuromyelitis optica, as well as other diseases like ulcerative colitis.”
To perform the test, the researchers put a blood sample into a long glass tube for nuclear magnetic resonance analysis, which uses radio waves and high magnetic fields to produce the “fingerprint” of the metabolites present in the blood © Oxford Cancer
“We are only really beginning to scratch the surface of what can be done with this technology and have high hopes for future discoveries as we explore what can be done,” said Larkin.
The team say that their new test will help patients who have symptoms that aren’t specific to cancer of a particular body part. Whereas some symptoms, like a lump, would cause a doctor to immediately test for cancer, there are others that may be missed or go undiagnosed for some time.
They hope that patients presenting these non-specific symptoms, such as fatigue or weight loss, could receive the cancer test as part of a routine blood test.
However, there is still a way to go before the new cancer blood test is being offered by GPs. Larkin says the key barrier is regulatory approval.
“Our next steps are to raise funding for a spinout company from Oxford University, and run a clinical validation trial with recruitment of patients from multiple sites across the UK,” said Larkin. “This will be 2,000 – 3,000 patients over the next two to three years, depending on the timing of a successful funding round. This trial will build evidence that we can submit to regulatory bodies, like the MHRA, for clinical approval.”
“The goal is to produce a test for cancer that any GP can request,” said Dr Fay Probert, lead researcher of the study. “We envisage that metabolomic analysis of the blood will allow accurate, timely and cost-effective triaging of patients with suspected cancer, and could allow better prioritisation of patients based on the additional early information this test provides on their disease.”
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