Saluting medical technology advances on World Cancer DayS. Himmelstein | February 04, 2019
Every year, nearly 9 million people worldwide die from cancer, and the continuing global fight against the disease demands new technologies and the latest available data.
The burden of this disease is expected to grow, afflicting 21 million patients and causing an estimated 13 million deaths per year by 2030 as the world’s population expands and ages.
Researchers are making progress in the development of equipment and technologies for the rapid diagnosis and effective treatment of various types of cancer.
Some of the more promising emerging technology R&D initiatives are worth noting in recognition of World Cancer Day, February 4.
Until recently, a biopsy was the only definitive way to know whether tissue was cancerous or not. The disadvantage to this approach is that few samples can be taken and tested during surgery, and it can take precious minutes to complete each test. This technique may not be the best way to define the edge of a tumor during surgery.
The iKnife, an intelligent surgical knife developed at Imperial College London, pairs electrosurgery with mass spectrometry. An electrical current heats tissue to make incisions with minimal blood loss. The resulting vaporized smoke is analyzed by a mass spectrometer to allow real-time identification of malignant tissue. This chemical profiling method quickly differentiates between healthy and suspected cancerous tissue.
Early detection of cancer biomarkers is the goal of the high-density profiling and enumeration by melt (HYPER-Melt) microfluidic platform. The digital system identifies subtle DNA changes in cancer cells that are hiding among many healthy cells. Even small changes like a single nucleotide on a single gene can give cancerous cells an advantage, and recognizing such alterations early can inform physicians and expedite medical intervention.
Testing for the human epidermal growth factor receptor 2 (HER2) protein as a biomarker for certain types of breast cancer requires a biopsy and frequently a two-week wait time to receive results. Researchers from the University of Connecticut and the University of Hartford have inkjet-printed what they say is an efficient, inexpensive and less invasive diagnostic solution.
In their technique, an electrochemical biosensor is fabricated with integrated electrodes for less than $0.25 and is designed to detect HER2 in a blood sample within 15 minutes. Nanoparticle inks are deposited onto a plastic substrate during the printing process to form an eight-electrode array coated with biomarker-specific antibodies. This component works in concert with a microfluidic device that directs blood flow through the sensor.
Another breast cancer diagnostic has been developed at the University of Cambridge, U.K.: an online tool that helps doctors predict a patient’s risk of developing the disease. The system combines information on family history and genetics with other factors such as weight, age at menopause, alcohol consumption and use of hormone replacement therapy. Considering these factors simultaneously can help identify groups of women who have different risks of developing breast cancer.
Surgery, chemotherapy, radiation and other treatments can eliminate many tumors. But once cancer spreads — or metastasizes — throughout the body, it becomes much harder to halt. Biosensors engineered at the University of California, San Diego School of Medicine can gauge the metastatic potential of individual cells based on the presence and modification of a specific protein.
Melanoma patients often endure the risks and side effects of surgery, radiation therapy and intravenous chemotherapy. Topical delivery of chemotherapy may enable patients to side-step these often painful and invasive procedures while targeting tumors in a more direct manner.
Researchers in China have formulated a paintable oligopeptide hydrogel containing the anti-cancer drug paclitaxel. The chemotherapy agent is encapsulated in transfersome nanoparticles composed of a phospholipid bilayer and surfactants that facilitate infiltration of the drug into the skin. A peptide added to the nanoparticle surface also promotes particle penetration of the skin as well as tumor cells.
A noninvasive method to deliver drugs to the brainstem, considered a high-risk target for surgical intervention, could be useful in addressing difficult-to-treat brain tumors. The technique developed at Washington University in St. Louis entails administering drugs through an intranasal spray, followed by use of focused ultrasound to allow the drug to penetrate and accumulate in deeper layers of the tissue. Therapeutic benefits are delivered to the ultrasound-targeted tissue.
Data collection and management
The development of databases and analytic tools in the cancer research and care communities is rapidly moving forward. However, without an infrastructure for sharing and integrating these resources, researchers and clinicians may miss important insights. To accelerate progress against cancer, patients and care providers must collaborate by sharing their collective data and knowledge about the disease.
A potentially attractive approach is crowdsourcing. This strategy allows people with rare and even common cancers to rapidly and directly affect research by sharing their tumor tissue samples and medical and/or genetic information to help others with the same or similar diseases. In return, researchers share what they learn with participants.
The Metastatic Breast Cancer Project collects health records and tumor and saliva samples to learn why some patients respond differently to cancer treatments than others. The project engages patients to participate via social media, newsletters, blogs and advocacy organizations.
The Cancer Atlas — produced by the American Cancer Society, the International Agency for Research on Cancer and the Union for International Cancer Control — provides a comprehensive global overview of information about the burden of cancer, associated risk factors, methods of prevention and measures of control. The Cancer Atlas aims to increase knowledge, provide a reliable basis for evidence-based decision making and inspire united action and partnerships against the cancer epidemic.
The American Cancer Society’s Cancer Statistics Center website offers a means to explore, interact with and share cancer statistics. The tool visualizes estimated new cancer cases and deaths by sex, state and cancer type in the current year, as are current cancer incidence, mortality and survival rate trends for individual cancer sites.
The Cancer Moonshot was launched at the federal level in 2016 to accelerate cancer research and make more therapies available to more patients, while also improving the ability to prevent cancer and detect it at an early stage. The U.S. National Institute of Health’s National Cancer Institute initiative seeks to accelerate progress in cancer research, encourage greater collaboration and improve the sharing of data.
A report describes 10 transformative research recommendations for achieving the goal of making a decade's worth of progress in cancer prevention, diagnosis and treatment in five years. These focus on using machine learning and natural language processing to create individualized cancer treatments, pairing machine learning with computer vision to help identify tumor progression and developing algorithms that help scientists understand how cancers develop and how to fight them.
Liquid biopsies assess mutations and other changes in DNA shed from tumors in the blood, providing insights into the earliest signs of cancer. In a report released in early 2018, Research and Markets projects the global liquid biopsy market will cross the $5 billion mark by the end of 2023. Currently, North America has the largest market for the liquid biopsy industry, and in 2016, the U.S. Food and Drug Administration approved the first liquid biopsy test for use in cancer.