UCLA researchers are pioneering a groundbreaking diagnostic test aimed at achieving same-day detection of leptomeningeal disease (LMD), a serious complication that occurs when cancer spreads to the central nervous system. This rapid testing could prove crucial for patients facing dire prognoses, as timely diagnosis and treatment are essential.
When cancer metastasizes from its primary site—such as the lungs or breast—to the brain or spine, established treatment protocols exist. However, LMD complicates matters significantly; it occurs when cancer infiltrates the cerebrospinal fluid (CSF), drastically reducing median survival rates to about four months with treatment, and mere weeks without it.
Current testing methods are inadequate, often requiring several weeks to confirm the presence of cancer in the CSF and additional time to assess treatment efficacy. Dr. Won Kim, Neurosurgical Director of the Brain Metastasis Program and co-investigator of the study, emphasizes the urgency: “You can’t wait a month or two to establish a diagnosis or see if treatment is working. That is critical time that we do not have.”
In a two-year study funded by the National Institutes of Health, Dr. Kim and Daniel Kamei, a professor of Bioengineering at the UCLA Samueli School of Engineering, are developing a test that would allow physicians to detect LMD on the same day as a patient’s visit. This innovation aims to enable real-time monitoring of treatment effectiveness, such as chemotherapy.
One of the main challenges lies in detecting very low concentrations of cancer cells in the CSF using a paper-based test. Kamei notes that while existing tests typically yield a simple “yes or no” answer, LMD diagnosis requires quantifying cancer cell concentrations. “For this application, you need to determine if the concentration of cancer cells is decreasing with a particular treatment regimen,” he explains.
The researchers are designing a diagnostic kit that includes sample processing and a specialized paper assay, similar to at-home COVID and pregnancy tests. This would allow doctors to draw CSF from patients, process it, and apply it to the test at the point of care. The goal is to confirm the presence of cancer cells and measure their concentration within the same day.
Existing tests necessitate lab processing, which can delay results by one to two weeks. Additionally, these tests typically only achieve a 50% detection rate on the first attempt, often requiring follow-up tests to improve accuracy. Kamei states, “The real-time monitoring of circulating tumor cells allows the doctor to quickly determine whether the treatment is working. This information is critical given the poor survival rates.”
In addition to speeding up diagnosis, the new test is expected to reduce costs due to its paper-based nature, which eliminates the need for extensive lab processing. Kamei adds, “The infrastructure is there to mass-produce these types of paper-based diagnostics with low cost and high shelf life.”
The NIH-funded study, totaling $375,000 over two years, will involve the development of two types of diagnostics and testing with both purchased cancer cells and patient samples. “If the technologies work with cancer cells, we will start testing with cerebrospinal fluid samples from patients,” Kim notes. “If validated, we aim to move towards a multicenter clinical trial.”
Date:17th,Oct 2024
Source: University of California – Los Angeles Health Sciences
