Multi-analyte Test Accurately Identifies Brain Cancers Using Small Cerebrospinal Fluid

A novel, multi-analyte trial developed by researchers astatine nan Johns Hopkins Kimmel Cancer Center, its Ludwig Center and nan Johns Hopkins Department of Neurosurgery tin accurately place encephalon cancers utilizing mini samples of cerebrospinal fluid (CSF), offering a promising caller instrumentality to guideline objective decision-making. 

The findings, supported by backing from nan National Institutes of Health, were published Aug. 25 successful Cancer Discovery and show that combining aggregate biologic markers, including tumor-derived DNA and immune compartment signatures, is much effective for diagnosing cardinal nervous system cancers than utilizing immoderate 1 marker alone. 

"This study highlights really overmuch much accusation we tin summation erstwhile we measure respective analytes together," says elder study writer Chetan Bettegowda, M.D., Ph.D., Harvey Cushing Professor and Director of nan Department of Neurosurgery astatine nan Johns Hopkins University School of Medicine, head of nan Reza Khatib Brain Tumor Research Center astatine Johns Hopkins, aesculapian head of nan Ludwig Center, and a elder writer connected nan study. "The expertise to observe cancers pinch precocious specificity and besides summation penetration into nan immune situation of nan encephalon could beryllium an important beforehand successful nan attraction of patients pinch encephalon tumors." 

To measure nan imaginable of a multi-analyte approach, investigators analyzed 206 CSF samples, including samples from patients pinch high-grade gliomas, medulloblastomas, metastases and cardinal tense strategy lymphomas. Their test, called CSF-BAM (cerebrospinal fluid–B/T compartment receptor, aneuploidy and mutation), measured chromosomal abnormalities, tumor-specific mutations, and T and B compartment receptor sequences. In combination, these markers identified encephalon cancers pinch much than 80% sensitivity (ability to observe cancer) and 100% specificity (correctly identified those who were cancer-free) successful nan validation cohort. The 100% specificity intends nary mendacious positives were recorded among individuals pinch noncancerous conditions. 

The study besides showed that nan assay could separate betwixt nan immune compartment populations coming successful crab and noncancer cases, offering further biologic discourse that could beryllium adjuvant successful more-challenging objective scenarios. Investigators opportunity this expertise to categorize T and B compartment populations in nan CSF provides insights into some illness beingness and immune response. 

Many patients pinch encephalon lesions look invasive diagnostic procedures to corroborate a crab diagnosis. A instrumentality for illustration this could thief america make better-informed decisions astir who really needs a biopsy and who doesn't."

Christopher Douville, M.D., adjunct professor of oncology and elder study author

Researchers opportunity nan trial could beryllium peculiarly useful for cases successful which accepted imaging aliases cytology is inconclusive, aliases successful situations erstwhile obtaining insubstantial for test is risky aliases not possible. The multi-analyte approach, they say, enables clinicians to amended observe crab and amended understand nan illness status, supporting a much tailored attack to diligent care.