WIN 2016
Serum miRNAs as diagnostic tools in GI malignancies
Dr Ajay Goel - Baylor University Medical Center, Waco, USA
What I presented today at this meeting was the role of RNAs, small RNAs, as potential liquid biopsy markers for detecting cancers, particularly gastrointestinal cancers. There is a lot of interest in small RNAs because these have been found to be very stable in cancer so we can easily find them, we can find them enough in numbers, we can find them in high specificity, which is very important, then whether they are specific for cancer patients or not. We can find them enough, it means they are very, very sensitive so we can detect them in blood, we can detect them in faeces, we can detect them in saliva. So the point is can we use these small RNA molecules for the early detection of cancers which is very, very important, especially when it comes to GI cancers, that if you can find these cancers early on you can help the patients a lot more. But so far the tools we have don’t help us because most cancer patients are diagnosed at a very late stage. So the big focus of our research has been early detection of cancers and we have what we will share today in this presentation was a lot of different sorts of evidence which point to the direction that these small RNAs are stable, they can be easily detected, they have some level of specificity, yes we need to work more but they offer specificity, and if we can come up with a good panel of markers we can really help the patients a lot more by early detection of their cancers.
Could you tell me about your work on predictive markers?
We are working on predictive markers as well, predicting which of these patients are going to develop metastatic disease, which of these patients are going to develop recurrence, which of these patients are not going to do so well. So we have quite a few markers which we can measure as liquid biopsies in serum or plasma of patients which can predict their risk for recurrent disease or a more high risk disease.
What challenge does tumour heterogeneity pose to RNA based treatments?
Yes, in terms of heterogeneity that’s a challenge and I think that’s where these small RNAs or even DNA based markers in liquid biopsy work better. Because when we do a physical biopsy of the tumour we know that the tumours are very heterogeneous so it’s possible that you can only pick a very selective number of cells and you obtain information, you gather everything and you determine the treatment plan and management of the patient based on those few cells. But those cells may be misleading, so having detection of these tumour cells in circulation, whether it’s DNA or RNA, probably offers a much more unbiased approach at looking at all of these cells freely floating in blood and then making a more informed decision which is probably more important, in some ways, of course we need to have more data but in some ways it may be more important than having physical biopsies.
Are there any upcoming trials?
At our institute we are in the process of initiating two or three different clinical trials where we are going to be looking at patients who have developed colorectal cancer, patients who have developed pancreatic cancer as well as oesophageal cancer. So we’re developing these trials for prospective enrolment of patients, drawing their tissues as well as blood at the same time so we can do match analysis and probably reach a panel of markers which can be used as liquid biopsy markers.
