Understanding the unique biology of a tumour can help doctors choose the best treatment and predict how the disease will progress. For some types of cancer, this information can be gathered through a simple blood test, which detects small pieces of genetic material that the tumour releases into the bloodstream.
Unfortunately, brain tumours don’t shed this material into the blood in the same way, making them harder to monitor non-invasively.
To solve this problem, Professor Petra Hamerlik and team are developing a new tool that uses tear fluid instead of blood. The idea is to detect a specific substance found in low-grade gliomas. This could help doctors diagnose these tumours earlier and more accurately - leading to more personalised and effective treatments.
Low-grade gliomas are slow-growing but incurable brain tumours that predominantly affect teenagers and young adults.
Treatment typically involves surgery to remove as much of the tumour as possible, followed by radiotherapy and then ongoing surveillance using MRI scanning. Sadly, all patients ultimately progress to a more aggressive high-grade glioma, at which point their prognosis is only around two years.
Some types of low-grade glioma have mutations in a gene called IDH. These mutations can help doctors to work out the best treatment strategy. However, detecting the mutation currently requires a biopsy or surgery - procedures that are invasive and can delay treatment decisions. It is also possible to detect the mutation in the cerebrospinal fluid (the fluid surrounding the brain and spinal cord) but collecting this fluid also carries risks.
In other cancers - such as breast and lung cancer - blood tests can detect tumour markers, like the IDH mutation. This doesn't work well for brain cancer, however, because the brain is protected by a barrier that stops tumour material from entering the blood stream.
Read more: About brain tumours
Professor Hamerlik's team is exploring a new and promising solution: using tear fluid to detect tumour markers.
Their focus is on a substance called D-2HG, which is only produced by tumours with the IDH mutation. They are developing a special sensor device that can detect D-2HG in tears.
This work is based on promising early lab results, demonstrating feasibility.
A non-invasive, simple diagnostic tool like this sensor device could bridge the gap between invasiveness and precision.
This means faster, more accurate diagnosis, a better understanding of prognosis, and more tailored treatment plans. It could also aid the selection and stratification of patients for clinical trials, speeding up the development and testing of new therapies.
This could help people like Louise, who was diagnosed with a low-grade glioma in 2019, at the age of 33. Four years after her initial surgery, following her six-monthly MRI scan, she received the news she'd been dreading - the tumour had regrown, and at speed. You can read her inspirational story here.
Professor Petra Hamerlik is a world-leading brain tumour researcher, with a focus on getting research from the lab to the clinic. She has pioneered the development of this study from its inception in Denmark.
In this project she brings together a team of experts from a range of fields - including neuroscience, cancer and bioengineering. They are uniquely placed to deliver this important project.
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