#United States #New York #Cancer Genetics #Ultra-Rapid Testing #Brain Surgery

Ultra-Rapid Testing for Cancer Genetics

In a significant advancement for cancer treatment technology, researchers from NYU Langone Health have developed an innovative tool known as Ultra-Rapid droplet digital PCR (UR-ddPCR). This groundbreaking method allows surgeons to swiftly identify the genetic fingerprints of cancer cells, particularly in brain surgeries, enhancing the precision of tumor removals while a patient is still on the operating table. This new testing approach has the potential to transform surgical oncology, specifically for brain cancers.

The research highlights the critical importance of accurately identifying various cancer types through the specific mutations present in abnormal DNA sequences. The UR-ddPCR tool stands out due to its remarkable speed, providing results within just 15 minutes — a stark contrast to the several hours required by traditional droplet digital PCR methods. With the capability to detect exceedingly small amounts of tumor cells (as few as five per square millimeter), this method represents the first practical application of real-time cancer detection in the operating room.

Dr. Daniel Orringer, a neurosurgeon involved in the research, accentuates the significant implications for surgical success, noting that effective cancer surgeries often depend on the complete removal of both the tumor and associated cancerous cells. He emphasizes that UR-ddPCR enables surgeons to determine the cancerous nature and quantity of cells at a level of accuracy previously unattainable.

In their study, published in the Cell Press journal Med, the team tested UR-ddPCR on over 75 tissue samples from 22 patients undergoing glioma tumor removals. The results were consistent with those produced by traditional ddPCR and genetic sequencing, validating the tool's reliability. Furthermore, UR-ddPCR was benchmarked against samples known to contain cancer cells and those confirmed to be cancer-free, confirming its efficacy.

The development of this ultra-rapid test involved refining the DNA extraction process, reducing the time from 30 minutes to under five, all while ensuring compatibility with the subsequent ddPCR stages. The team also optimized the concentrations of chemicals used in PCR testing, decreasing the time needed for specific steps significantly. By employing pre-warmed reaction vessels that eliminated unnecessary temperature cycling, they achieved further efficiencies, ultimately reducing the overall testing duration.

During clinical evaluations, the researchers focused on measuring two genetic mutations prominently associated with brain cancers: IDH1 R132H and BRAF V600E. Additionally, combining UR-ddPCR with a previously developed technique, stimulated Raman histology, allowed for accurate assessments of tumor cell density and distribution in tissue samples.

Despite promising results so far, the team acknowledges that broader implementation of UR-ddPCR awaits further refinements and thorough clinical trials. Future goals include automating the testing process further, aiming for smoother operational integration in surgical environments. The researchers are also looking into expanding the technology to detect other critical genetic mutations in various cancer types beyond the brain.

Funding for this pivotal study was provided by the National Institutes of Health, demonstrating an ongoing commitment to advancing cancer diagnostics. The application of UR-ddPCR could open new frontiers in personalized medicine, potentially improving outcomes for patients battling various forms of cancer.

As the field advances, researchers remain focused on ensuring that these innovations translate into improved patient outcomes. The collaborative efforts of NYU Langone's multidisciplinary research team signal a bright future for the integration of rapid genetic testing in clinical oncology, ultimately contributing to more effective and less invasive cancer surgeries.