A microfluidic blood-based test to monitor treatment response in glioblastoma

一种基于血液的微流体测试，用于监测胶质母细胞瘤的治疗反应

• 批准号: 9789656
• 负责人: Brian Vala Nahed
• 金额: $ 43.76万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-20 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9789656
• 关键词: Address; Biological Assay; Biological Markers; Biology; Biopsy; Blood; Blood - brain barrier anatomy; Blood Tests; Brain Neoplasms; Caring; Cells; Classification; Clinic; Clinical; Clinical Trials; Complement; DNA; Data; Data Set; Detection; Development; Devices; Diagnosis; Diagnostic radiologic examination; Disease; Enrollment; Evolution; Failure; Frequencies; General Hospitals; Genomics; Glioblastoma; Glioma; Goals; Grant; Histologic; Image; Investigational Therapies; Laboratories; Magnetic Resonance Imaging; Malignant Neoplasms; Massachusetts; Microfluidic Microchips; Microfluidics; Molecular; Molecular Genetics; Monitor; Morbidity - disease rate; Mutation; Mutation Analysis; Neoplasm Circulating Cells; Neoplasm Metastasis; Operative Surgical Procedures; Pathologic; Patient Care; Patient Monitoring; Patients; Postoperative Period; Prediction of Response to Therapy; Proteins; Proteomics; Protocols documentation; RNA; Radiation necrosis; Radiation therapy; Recurrence; Reproducibility; Sampling; Series; Signal Transduction; Source; Stream; Techniques; Technology; Testing; Time; Tissues; Translating; Treatment Side Effects; Tube; Tumor Burden; Vascular Proliferation; base; biomarker discovery; cancer cell; chemoradiation; chemotherapy; chromatin immunoprecipitation; clinically relevant; cohort; cost; design; digital; exosome; experience; extracellular vesicles; genetic information; improved; liquid biopsy; microfluidic technology; minimally invasive; molecular marker; next generation sequencing; novel; particle; patient population; response; response biomarker; therapy resistant; transcriptome sequencing; treatment response; tumor; tumor DNA; tumor progression; vesicular release

PROJECT SUMMARY The diagnosis and monitoring of patients with glioblastoma requires both surgery and magnetic resonance imaging in complement. Surgery critically provides tissue for histological and molecular characterization and MRI facilitates subsequent monitoring despite its limitation to differentiate between treatment response (radiation necrosis) and failure (tumor recurrence). As a result, patients undergo an additional surgical procedure to obtain tissue for molecular characterization, and to distinguish treatment response from failure requiring a change in therapy. Given the morbidity associated with surgery, patients cannot undergo serial biopsies therefore a minimally invasive test would provide real-time analysis and change our understanding and management of glioblastoma. Our laboratory is the first to identify both circulating tumor cells (CTCs) and exosomes (EVs) in the blood of patients with glioblastoma. In other cancers, CTCs and EVs have been independently captured, characterized, and analyzed to provide real-time information of the patient's tumor burden and identifying new mutations that confer resistance to therapy. Despite the blood brain barrier, EVs and CTCs are found in the blood in high and low frequencies. Currently, no existing technology exists to simultaneously capture and monitor both EVs and CTCs in patient blood. Thus, we propose the use of microfluidics to develop and validate our blood based `liquid biopsy' to isolate both EVs and CTCs from a single tube of blood from patients with glioblastoma at diagnosis and throughout treatment. We will also use standard techniques to evaluate ctDNA in parallel to evaluate any additive benefit to our assay. Microfluidic processing of clinical samples is low cost and shows great promise for translating `blood-on-a-chip' assays to the clinic. Our assay will allow for real-time molecular characterization throughout therapy and potentially identify novel treatments or better match patients with existing clinical trials. In addition, we aim to more accurately determine treatment response and inevitable recurrence using next generation sequencing of CTCs, EVs and ctDNA from diagnosis onward; ultimately establishing a minimally invasive test to diagnose, monitor, and detect recurrence in patients with glioblastoma. The new 2016 WHO classification of brain tumors has added molecular markers to the pathological diagnosis of glioblastoma which has traditionally required surgical tissue; we aim through our liquid biopsy to provide the first molecular characterization and classification of brain tumors through a simple blood test in real-time. This will dramatically advance our understanding and the care of patients with glioblastoma.

项目摘要 胶质母细胞瘤患者的诊断和监测需要手术和磁共振 补充成像。手术对组织学和分子表征和MRI进行严格的组织提供组织 尽管限制了治疗反应（辐射），但仍促进随后的监测 坏死）和失败（肿瘤复发）。结果，患者接受了额外的外科手术以获得 用于分子表征的组织，并区分治疗反应与需要改变的失败 治疗。鉴于与手术相关的发病率，患者不能进行连续活检 微创测试将提供实时分析，并改变我们对 胶质母细胞瘤。我们的实验室是第一个识别循环肿瘤细胞（CTC）和外泌体（EV）的实验室。 胶质母细胞瘤患者的血液。在其他癌症中，CTC和电动汽车已被独立捕获， 特征和分析以提供患者肿瘤负担的实时信息并确定新的 赋予对治疗的抗性的突变。尽管有血脑屏障，但在血液中发现了电动汽车和CTC 在高频和低频中。目前，尚无现有技术可以同时捕获和监视 患者血液中的电动汽车和CTC。因此，我们建议使用微流体来发展和验证我们的血液 基于胶质母细胞瘤患者的单管血液中的EV和CTC分离出基于“液体活检” 诊断和整个治疗。我们还将使用标准技术并行评估ctDNA 评估我们测定的任何添加剂。临床样品的微流体处理是低成本，并且表现出色 将“血液中的芯片”测定法转换为诊所的承诺。我们的测定将允许实时分子 整个疗法的表征，并有可能识别新型治疗或更好地匹配患者 现有的临床试验。此外，我们旨在更准确地确定治疗反应和不可避免的 从诊断开始使用CTC，EV和CTDNA的下一代测序的复发；最终 建立微创测试，以诊断，监测和检测胶质母细胞瘤患者的复发。 新的2016年脑肿瘤分类已为病理诊断增加了分子标记 传统上需要手术组织的胶质母细胞瘤；我们旨在通过液体活检提供第一个 通过实时的简单血液检查对脑肿瘤的分子表征和分类。这会 急剧提高了我们的理解和胶质母细胞瘤患者的护理。