By Eric Wicklund, mHealth Intelligence | April 1, 2019

Researchers at the University of Michigan are working on an mHealth wearable that screens blood for a period of time, filtering out dangerous cancer cells for analysis. It could prove more effective than a traditional biopsy.

Researchers in Michigan are working on an mHealth wearable that could help doctors identify cancer with more accuracy than a biopsy.

The device, which attaches to the arm and filters live cancer cells from blood cycled from a vein over  a couple of hours, has been safe-tested on dogs at Colorado State University’s Flint Animal Cancer Center, where it captured 3.5 times more cancer cells than a traditional biopsy. In humans, the mobile health platform could be used to screen and detect metastases, deadly cells that spread the disease.

“Nobody wants to have a biopsy; if we could get enough cancer cells from the blood, we could use them to learn about the tumor biology and direct care for the patients,” Daniel F. Hayes, MD, the Stuart B. Padnos Professor of Breast Cancer research at the University of Michigan Rogel Cancer Center, said in a press release from the university. “That’s the excitement of why we’re doing this.”

“It’s the difference between having a security camera that takes a snapshot of a door every five minutes or takes a video,” added Sunitha Nagrath, PhD, an associate professor of chemical engineering at UM  who led the development of the device and part of the Rogel Cancer Center and the Biointerfaces Institute. “If an intruder enters between the snapshots, you wouldn’t know about it.”

As explained in a recent paper in Nature Communications, blood draws capture a very small percentage of blood, which may or may not contain cancer cells. And while many cancer cells don’t survive in the blood stream, those that do – circulating tumor cells (CTCs), or metastases – are more likely to create new tumors.

“Using modern technologies, several studies have now demonstrated that elevated levels of CTC isolated from a single blood draw are prognostic in patients with metastatic breast, colorectal, prostate, and lung cancers, as well as early stage breast and prostate cancers,” the paper points out. “Furthermore, CTC analysis holds promise for predicting benefit from targeted therapies, pharmacodynamic monitoring during treatment, and insight into the biology of metastases. Indeed, CTC evaluation might be used for early detection of malignancy, if an assay with sufficient sensitivity and specificity could be developed.”

A telemedicine platform that filters blood for a specified period of time, meanwhile, has a much better chance of snagging some of those cells and helping doctors better identify and treat cancer. Researchers likened the device to a Holter monitor, an mHealth wearable that monitors cardiac arrhythmias over a period of time.

The device uses a graphene oxide chip “to create dense forests of antibody-tipped molecular chains, enabling it to trap more than 80 percent of the cancer cells in whole blood that flows across it.” It can also grow captured cancer cells, giving clinicians larger sample sizes to analyze.

“Tumor biomarker assays may have clinical utility in one of several use contexts, including risk categorization, screening for undetected cancers at early stage, differential diagnosis, prognosis-independent of therapy, prediction of benefit of therapy, and serial monitoring to determine the state of the cancer,” the paper noted. “Currently, CTC have been shown to have clinical validity as a prognostic factor in early stage breast cancer and in the metastatic setting in several epithelial malignancies. The reliability and higher recovery rate from long-term, large blood volume scans might broaden the clinical applicability of CTCs for many of the other use contexts, particularly through further downstream genotyping and molecular characterization without the need for sophisticated CTC culture techniques.”

Hayes and his colleagues hope to have the device ready for human trials in three to five years.

“This is the epitome of precision medicine, which is so exciting in the field of oncology right now,” he said.