New blood testing method promises personalized cancer treatment

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Oncologists use biopsy and imaging techniques to diagnose and monitor tumor diseases and to assess the success of treatments. UZH and USZ researchers have now developed an advanced method for analysing liquid biopsies of DNA fragments in the blood. It is fast and practical, without causing much stress to patients. This could make it possible to provide more closely tailored diagnoses and treatments for individual patients in the future.

The sooner the cancer is detected, the better the chance that the treatment will be effective. This applies to almost all types of cancer. Another important element in successfully treating patients is to individually assess the benefits and risks of different forms of therapy and to regularly monitor the success of the treatment. To do this, oncologists have a variety of methods at their disposal, most notably imaging techniques and invasive measures such as tissue biopsy, puncture and endoscopic procedures.

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Analysis of gene fragments in the bloodstream

Researchers at the University of Zurich (UZH) and the University Hospital Zurich (USZ) have now developed an advanced method, a type of liquid biopsy that analyzes blood samples instead of organs or tissues. The method sequences and analyzes DNA fragments circulating in patients' blood. “Our method can be used in the future for risk assessment, treatment monitoring during follow-up care and early detection of cancer recurrence, in principle for all types of tumors,” says Zsolt Balazs, co-first author of the study at the Department of Quantitative Biomedicine at UZH.

Since this method is based on blood samples, it is less invasive than performing a tissue biopsy. In addition, taking blood samples is faster and more practical in day-to-day hospital operations, as fewer appointments are needed for diagnostic interventions, allowing those affected to avoid long waiting times.

Customized treatment approach

The new method of analysing liquid biopsies could help oncologists determine tumour activity and spread more precisely. This would allow them to develop treatments that are tailored to individual patients. “We can see earlier and more quickly how far cancer has spread in the body and how well a patient is responding to a specific treatment, or whether a disease may recur,” says Zsolt Balazs.

In the laboratory, the researchers analyzed gene fragments circulating in the blood for changes in the DNA that are characteristic of specific types of cancer. The method analyzed changes in the number and length distribution of the fragments. “The liquid biopsy technique enables us to discriminate between biologically less and more aggressive metastatic cancer disease – perhaps even earlier than using imaging techniques,” says co-first author Panagiotis Balarampas, professor in the Department of Radiation Oncology at USZ.

Greater focus on patients' quality of life

The researchers tested their method on patients undergoing radiotherapy, including many HPV-positive patients. HPV stands for human papillomavirus, which can also cause cancer. The number of HPV DNA fragments found in the blood helped the researchers observe tumor growth. For head and neck cancers, they found that high concentrations of HPV DNA could be an early sign of cancer recurrence, which could be combated using immunotherapy.

“The more the tumor metastasizes, the worse the patient's quality of life becomes. This also applies to local recurrences that are not detected early. It is important that we individualize treatment as much as possible, taking into account the potential benefits of all treatments as well as their impact on the patient's quality of life,” concluded Balerempas, who oversaw the treatment of patients with head and neck tumors in the study.

Reference: Balaz Z, Balerampas P, Ivankovic I, et al. Longitudinal cell-free DNA characterization by low-coverage whole-genome sequencing in patients undergoing high-dose radiotherapy. radiotherapy oncol. 2024;197:110364. doi: 10.1016/j.radonc.2024.110364

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