In This Video
- Brian Nahed, MD, MSc, and Shannon Stott, PhD, of Massachusetts General Hospital, have developed a blood-based assay called liquid biopsy
- Liquid biopsy is a non-invasive procedure that allows physicians to monitor a patient's tumor during treatment
- Liquid biopsy has the potential to improve both safety and efficacy of brain tumor diagnoses
Brian Nahed, MD, MSc, associate director of the Massachusetts General Hospital Neurosurgery Program, and Shannon Stott, PhD, assistant in genetics at Mass General, discuss their collaborative research on liquid biopsy.
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Dr. Nahed: The field of liquid biopsy particularly with brain tumors is very exciting. The ability to diagnose through the blood and not use a craniotomy or a surgical procedure is something that all of us in the field would love to have.
Dr. Stott: Dr. Nahed and I are working towards developing a blood-based assay so that we can learn more about a patient's tumor as it progresses through treatment.
Dr. Nahed: We approach if from two different angles. I come at it from a more clinical angle, and she brings a wealth of engineering and scientific background to this. We've combined our efforts.
Dr. Stott: My role in that effort is to bring my mechanical engineering background to develop microfluidic devices so that we can manipulate individual particles that are inside whole blood, so that we can pull as much information out from that tube of blood, so that we can guide the patient's treatment.
Dr. Nahed: Several years ago we were the first to identify circulating tumor cells in the blood of patients with brain tumors. This exciting and groundbreaking discovery allowed us to, for the first time, look in blood and be able to pull out cancer cells, which were very similar to what I would do in the operating room.
Dr. Stott: One of the things that we've seen at very early stages is that if we can isolate even just a few, as small as four cancer cells, from a patient's blood draw, we are able to expand those cells out in culture. Why that's important is because if those cells can be expanded, we can then put hundreds and thousands of these cells in multiple different wells, and test out different combinations and doses of different therapeutics that could be an option for this patient. Then for you and your cells that we've been able to culture, we can see what is the specific therapeutic that is going to work best for you, not everyone else.
Dr. Nahed: What's even more exciting is traditionally we were only able to identify a brain tumor or diagnose one at maybe one or two time points in a patient's disease course, but with a blood test we can do it at any time in real time while we're giving therapy.
Where I see the future of this is, as you give somebody chemotherapy or radiation therapy their brain tumor is likely changing, and we have no way of knowing what those changes are. The liquid biopsy field, and particularly our tests, we hope will one day be able to identify those changes, identify new targets and help us target those.
Dr. Stott: We've also since expanded this work to pediatric cancers where we can look to see in this most vulnerable population where we might not have as much blood, but the microfluidics is the perfect pairing where we can take small sample volumes and get as much information as we can.
Since we started on this project we have seen the technology evolve, and we've had multiple generations develop. Specifically right now, our latest generation, the CTC-iCHIP is being scaled up as a startup company based here in Boston. It's referred to as Torpedo Diagnostics.
We're now taking this technology and expanding what we've learned from thousands of patients that have been run here at Mass General, but by doing a large scale clinical trial, so that we can run thousands of patients, but with one particular cancer under one particular treatment so that information can be used to actually guide that patient's treatment.
Dr. Nahed: Our hope through our clinical colleagues as well as our research colleagues is to advance the level of care for all brain tumor patients. It's not enough to just say we're aggressive. What we really want to be is aggressive and safe so that we can provide not only the answers for today, but the answers that are around the block for tomorrow.
Learn more about Dr. Nahed's research
Learn more about the Stott Laboratory