New minimally invasive diagnostic technology for brain cancers
Currently, there is no way to accurately diagnose the presence of brain tumors without actually cutting into the skull. Nor is there a reliable method for monitoring the progression of brain cancer. But in a paper, published online in the journal Neuro-Oncology, an international group of researchers at UC San Diego Moores Cancer Center, the Brigham and Women’s Hospital and Georg-August University in Germany describe a non-surgical method that may do both with remarkable accuracy.
In a study of 118 patients with different types of brain cancers, researchers focused on the presence and abundance of different microRNAs in patients’ cerebrospinal fluid (CSF). MicroRNAs are short, single-stranded RNA molecules that help regulate gene expression. They have proven to be effective biomarkers for other conditions and can be accurately measured simply and inexpensively.
That utility appears to hold true for brain cancer as well. The scientists report that they found significantly increased levels of two specific types of miRNA in the CSF of patients with glioblastoma and brain metastasis of breast and lung cancer, compared to tumors in remission and a variety of non-neoplastic conditions.
Patients with brain metastases but no other pathologic conditions showed highly elevated levels of other types of miRNA, allowing researchers to discriminate between glioblastoma and metastatic brain tumors.
The scientists were able to achieve these diagnoses by measuring as few as seven miRNAs. Their accuracy rate was very high: 91 to 99 percent.
In addition, they reported that disease activity and treatment response can be monitored by regularly profiling microRNA levels in the CSF of glioblastoma and non-small cell lung carcinoma patients.
"This is just the beginning,” said co-senior author Santosh Kesari, MD, PhD, director of Neuro-Oncology and Translational Neuro-Oncology Laboratories at UC San Diego. “We will continue to lead discovers of novel biomarkers in CSF, blood and other body fluids using the latest technologies to better detect oncological and neurological diseases which will allow us to optimize outcomes in our patients.”
“The test needs to be further developed before it is used in a clinical setting,” said Kesari, “but I expect it could be particularly valuable for patients who are not surgical candidates due to the tumor’s size or location, or due to an underlying medical condition.”
Scott Lippman, MD, the new director of the UC San Diego Moores Cancer Center, lauded the international collaboration and its potential: “This work exemplifies our renewed emphasis on translating molecular discovery into clinical advances that improve the lives of patients here and worldwide.”