Cancer test treats patients with precision

dna tests — Image caption A DNA test of a cancer tumour could provide huge amounts of information

Scientists at Glasgow University have developed a cancer testing technique that they say could transform the way we treat the disease.

The medical team based at The Glasgow Precision Oncology Laboratory are able to extract huge amounts of information from tiny fragments of DNA.

The information could identify the type of cancer tumour as well as any genetic variations and its resistance to drugs.

It could even point to a cancer patient’s prognosis.

It is what is known as “precision medicine”, because it could allow doctors to match treatments to individual patients.

Image caption Prof Andrew Biankin said cancers that might look similar under the microscope are different at a genetic level

Andrew Biankin, regius professor of surgery at Glasgow University, said that it was all about “getting the right treatment to the patient at the right time”.

Prof Biankin, an international expert in genetic research and precision oncology, said methods of measuring differences in disease have been “relatively crude”.

He said: “In cancer we use a microscope to look at the differences in what we see in the individual cells, that gives us a certain granularity.

“So we can group things to a certain degree but many of the treatments we use don’t work in most patients.”

Image caption The DNA from cancer tumour is broken down into fragments that can be targeted for analysis

Prof Biankin said the treatments might work in 20% or 30% of patients but they never know that ahead of trying them.

“We don’t want to wait three months or six months to say ‘oh dear it’s not working, lets try something different’,” he said.

“In a disease like pancreatic cancer, six months might be the end, so we need to be able to select which treatment comes first.”

The professor said cancers that might look similar under the microscope are different at a genetic level.

“It makes sense that if we are trying new treatments we should try to match it to the underlying genetics, or molecular pathology as it is called, of an individual’s cancer,” he said.

The test was originally developed to help understand the make-up of pancreatic cancer where fewer than three in every 100 patients will live for five years.

Prof Biankin and his team sequenced genes to understand which particular type of pancreatic cancer a patient had.

Now the laboratory is sequencing DNA samples from all types of solid tumours to improve understanding of the disease.

Not only will that help the patient but it will also allow data to be collected in a standardised way.

That will improve research and enable people to access new treatments.

In the laboratory, scientists enlist the help of a robot to sort and filter DNA samples from a patient’s biopsy.

It is able to extract the 1% that is relevant to cancer.

After that the samples are sequenced and powerful computers analyse the data.

Image caption Dr Susie Cook said she hoped all cancer patients would get the genomic test

Dr Susie Cook, the head of medical genomics at GPOL, explains that it would take a team of people days just to extract the relevant fragments of DNA.

Having a robot do the work means they can test more than 90 samples in one go.

With about 80 people diagnosed with cancer every day in Scotland she believes the potential for this test is a game-changer.

Dr Cook said: “I really hope well within five years time every patient who is diagnosed with cancer will get one of these all-encompassing genomic tests.

“They’ll get it early in their care pathway so it’s one of the first things that happens once they are diagnosed with cancer and it will allow them to use that information and their doctors to use that information every step of the way.”

The goal has been to develop a test readily available to all NHS patients. Genomic testing of cancer is generally a difficult and expensive option accessible to only a few.

But the university says what is different here, is that this test is comprehensive, practical and affordable – a few hundred pounds rather than in the thousands.

It is about to be piloted by NHS Greater Glasgow and Clyde with health boards across the UK and internationally also in talks about bringing this tiny but potentially revolutionary test to a hospital near you.