early detection Archives - NFCR

early detection

Non-Invasive Liquid Biopsy Uncovers Key Information to Treat Cancer

A liquid biopsy can provide valuable insight into how to best fight cancer. This noninvasive diagnostic is particularly helpful for patients who cannot undergo a surgical biopsy or whose tumor sample has been exhausted. In the not-too-distant future, liquid biopsies may be used to guide cancer treatment decisions and even screen for tumors that are not yet visible through imaging.

Liquid biopsies are a non-invasive alternative to surgical biopsies which enables doctors to discover a range of information about a tumor through a simple blood sample. In addition to providing a current picture of a patient’s cancer, liquid biopsies can be used for early detection of cancer, to monitor responses to treatment, give an early warning about possible recurrence and help explain why some cancers are resistant to treatment.

New study released by Dr. Wei Zhang

NFCR-funded scientist Dr. Wei Zhang of the Precision Oncology Center of Wake Forest Baptist Comprehensive Cancer Center (WFBCCC) just released the latest results of his study using liquid biopsies in a paper entitled “Circulating mutational portrait of cancer: manifestation of aggressive clonal events in both early and late stages” which was published in the Journal of Hematology & Oncology.

In this study, Dr. Zhang and his team isolated circulating tumor DNA (ctDNA) from the plasma of 177 patients diagnosed with cancer at both early and advanced stages. The majority of these patients (103 patients) had lung cancer, while the remaining 74 patients had been diagnosed with other solid tumor cancers including head and neck, colorectal, pancreatic, gastric and other cancer types. The team then performed next generation DNA sequencing to identify mutations in a panel of key cancer-causing genes from the plasma samples.  Key findings include:

  • Mutations in TP53, EGFR, and KRAS genes were most prevalent in this study, and mutations in BRCA1, BRCA2, and ATM were found in 18.1% of cases.
  • Mutation rates (number of mutations) of ctDNA were similar in early (I and II) and late stage (III and IV) cancers.
  • Patients with higher mutation rates had significantly higher mortality rates.
  • Lung cancer of never smokers exhibited significantly higher ctDNA mutation rates as well as higher EGFRand ERBB2 mutations than ever smokers.
  • Mutations of key genes found in the tumor tissue could remain in circulation even after frontline radiotherapy and chemotherapy, suggesting these mutations represented resistance mechanisms.
  • Five lung cancer patients known to have EGFR mutations in their tumor were monitored through multiple plasma sampling and ctDNA tests over time. Results showed distinct changes in ctDNA mutation portraits that are consistent with cancer progression or response to EGFR drug treatment.  This experiment further substantiated the benefits of repeated liquid biopsy as a substitute of invasive tumor biopsy for continued disease monitoring and treatment adjustment based on changes in gene mutations of the tumor.

    Bench to bedside: Integrating research into today’s treatments

    Wei ZhangDr. Zhang’s research demonstrates that liquid biopsy can be an effective, non-invasive, pain-free tool to identify driver mutations or mutations that sensitize or resist treatments as well as monitor cancer progression. Detection of ctDNA (circulating tumor DNA) in a liquid biopsy can also be a non-invasive early detection method for screening high risk populations such as smokers leading to real-time changes in treatment.

    In certain instances, such as with many lung cancers, new gene mutations occur as the cancer is treated or even progresses. To assess these changes, new tumor sample is needed, but repeated surgical biopsies are risky, painful and often times, simply not feasible to obtain. On the other hand, a liquid biopsy would allow doctors to obtain multiple samplings over a period of time easily and without harm to the patient.

    Liquid biopsy will become a powerful next generation tool that may lead to a brighter future in patient care‑  one where early diagnosis  and the delivery of more effective treatments could be managed with a simple blood draw.


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6 Facts You Need to Know About Kidney Cancer

March is National Kidney Cancer Awareness Month and, as this disease continues affecting the lives of so many people every year, it’s important to understand it.


  • Kidney cancer is among the 10 most common cancers in both men and women.
  • In the United States, an estimated 63,990 people will be diagnosed with kidney cancer this year.
  • While the number of people diagnosed with kidney cancer has been slowly rising since the 1990’s, the death rate has been slowly declining.
  • The overall (all stages included) five-year survival rate for people with kidney cancer is 74%.[i]

Here’s a list of six facts you need to know about kidney cancer. And make sure you read about related work by NFCR-funded scientist Dr. Wayne Marasco.

1. Men are twice as likely to develop kidney cancer.

An estimated 40,610 men and 23,380 women in the U.S. are expected to be diagnosed with kidney cancer this year.[ii] That means nearly twice as many men will be diagnosed! Yet the exact reasons for this difference are unknown. Possible factors include higher levels of chemical exposure and higher smoking rates. Men are more likely to be smokers and are more likely to be exposed to cancer-causing chemicals at work.[iii]

2. Kidney cancer most often occurs in people over age 55.

The risk for developing kidney cancer increases with age and the average age of diagnosis is 64 years old. Although kidney cancer is very uncommon in people younger than age 45, there is a type of kidney cancer, known as Wilms tumors, that tends to affect children. About 5% of all cancers in children are Wilms tumors.[iv]

3. Smoking and other factors increase risk.

Smoking has been linked with as many as one third of all kidney cancer cases.[v] And if you are a current or former smoker, your risk of developing kidney cancer is twice as high as someone who never smoked. Quitting reduces your risk, even if you’ve smoked for years.

Other major risk factors include obesity, high blood pressure and exposure to chemicals like asbestos and cadmium. In addition, people who receive long-term dialysis to treat kidney failure have a higher risk of developing kidney cancer.

4. Pay close attention to your family history.

Your family history may predispose you to kidney cancer. If you have a first-degree relative (mother, father, brother, sister or child) who was diagnosed with kidney cancer, you are at increased risk of developing the disease. This risk is highest for brothers or sisters of those with the cancer.[vi]

Also, people born with certain inherited syndromes may have an increased risk of kidney cancer, including those who have von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis and familial papillary renal cell carcinoma.

5. There are warning signs, but not EARLY warning signs.

Like lung cancer, colorectal cancer and cervical cancer, kidney cancer rarely causes signs or symptoms in its early stages.

Possible warning signs or symptoms may include: blood in your urine (this may be painless and appear one day and not the next); back pain just below the ribs that doesn’t go away and was not caused by injury; weight loss; fatigue; or intermittent fever. If you notice any of these symptoms, see your doctor right away.

6. Cutting-edge research is helping us attack kidney cancer head on.

Battling Renal Cell Carcinoma with Mabs

For cancer, as well as HIV/AIDS and other infectious diseases, one possible treatment involves the use of human monoclonal antibodies (Mabs) – which are proteins that scientists develop to bind to only one substance. For cancer treatments, Mabs bind only to cancer cells and produce immunological responses against the cancer cells. There is great promise with Mabs because their tumor-fighting effects would be less harmful to normal cells than that of traditional cancer treatments.

In an effort to greatly expand the use of Mabs in the treatment of cancer, Dr. Wayne Marasco— a world-renowned antibody engineering expert who works on infectious diseases and cancer immunotherapies — and NFCR joined forces to create the NFCR Center for Therapeutic Antibody Engineering. At the Center, Dr. Marasco collaborates with accomplished global cancer investigators in a joint effort to uncover new Mabs using his laboratory’s huge human antibody library.

Most recently, his team at the NFCR Center developed a combination immunotherapy treatment that holds promise for treating metastatic kidney cancer more effectively. The immunotherapy they have engineered includes not only the CAIX antibody that detects and binds to CAIX growth-promoting proteins on cancerous kidney cells, but also unblocks T cells to enable more rigorous attacks against cancer. Moreover, this double treatment approach could be adapted to treat advanced colon, breast, brain and other difficult-to-treat solid cancers using different antibodies.

[ii] https://www.cancer.org/cancer/kidney-cancer/about/key-statistics.html
[iii] https://www.cancer.org/cancer/kidney-cancer/causes-risks-prevention/risk-factors.html
[iv] https://www.cancer.org/cancer/wilms-tumor/about/key-statistics.html
[v] http://www.kidneycancerkonnection.com/
[vi] https://www.cancer.org/cancer/kidney-cancer/causes-risks-prevention/risk-factors.html

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