?Whats new in cancer diagnostic testing
المؤلف:
Mary Louise Turgeon
المصدر:
Immunology & Serology in Laboratory Medicine
الجزء والصفحة:
5th E, P487
2025-11-13
19
Next Generation Sequencing (NGS) Next Generation Sequencing (NGS) as described in Chapter 14, Molecular Techniques, is another step toward personalized cancer treatment. Three aspects of importance in NGS are:
1. Identification of somatic mutations
2. Detection of low levels of genomic alterations
3. Improved management of cancer treatment
Identification of Somatic Mutations
The genetic fingerprint reveals the somatic alteration of cancer genomes. Genetic changes that are associated with cancer include a single nucleotide change or structural chromosomal changes. Only some acquired genetic alterations are clinically significant.
Detection of Low Levels of Genomic Alterations
NCs has higher sensitivity of mutations in cells than traditional Sanger genome sequencing. This allows for better detection of changes occurring in only a small number of cells.
Improved Management of Cancer Treatment
Accurate diagnosis of cancer, including leukemias, is dependent on accurate molecular profiling. This contributes to improved treatment and the ability to predict prognosis.
The goal of NGS technology is to be able to quickly generate data from a small sample of tissue from a tumor.
Continuous Field-Flow Assisted Dielectropheresis (DEP)
The ability to isolate and characterize rare circulating tumor cells (CTCs) may provide critical insights into primary tumors, the process of metastasis, and monitor disease progression. Per forming molecular analysis of CTCs offers a unique approach for genotyping patient-specific tumors and mutations as well as guiding treatment options.
To date, only one technology is FDA approved for use with only three tumor types: prostate, breast, and colorectal cancers. The new technology is antibody-dependent, that means the detection and capture of CTCs depends on antigen expression of the surface of cancer cells of epithelial origin, e.g., EpCAM. A new, next-generation antibody independent technology has recently been developed. It relies on continuous field-flow assisted dielectropheresis (DEP) to isolate and recover CTCs from the blood of cancer patients. This technology has already proven to be successful in detecting and isolating a wider range of cancers in greater cells quantities, and research protypes are now being used in phase I, phase II, and phase III clinical studies. The isolation of rare cells from blood using DEP field-flow assist is based on the differences in dielectric properties between bloods, e.g., lymphocytes, monocytes, and granulocytes, and solid tissue-deprived cancer cells. This technology is revolutionary because:
1. It permits the isolation of cancer cells from all types of cancer, e.g., lung, prostate, melanoma, breast, pancreatic, and liver.
2. The higher CTC isolation and capture capability provides greater opportunities for downstream analysis of cancer cells for treatment options and monitoring of effectiveness.
3. DEP technology captures the cancer cells in a viable state that allows for additional biological testing.
Future applications of this technology are being explored to facilitate implementation of personalized medicine with improved clinical outcomes.
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