Patients who have aggressive prostate cancer could be identified by a highly accurate and simple blood test, according to an early study by Queen Mary University of London (QMUL).
The research discovered rare cells in the blood that could be used to identify patients who are 10 times more likely to die of their prostate cancer, allowing targeted treatments to be offered as early as possible.
Prostate cancer is the most common cancer in Western men and the fourth most common overall, with more than 1.1 million new cases recorded in 2012. Identifying patients with aggressive cancer could have major implications for their treatment; however, methods to detect whether the cancer has spread (metastasis) are costly and expose patients to radiation. A simple blood test that is accurate and has the ability to predict earlier whether the prostate cancer has become metastatic would meet a key unmet medical need.
The study, published in the journal Clinical Cancer Research, analysed blood samples from 81 prostate cancer patients using a new cell capture technology called Parsortix™ developed by the British company ANGLE plc. Unlike many other systems, the Parsortix system captures all types of circulating tumour cells (CTCs) -- cancer cells that have left the original tumour and entered the bloodstream prior to spreading around the body.
Metastasis is responsible for over 90 per cent of cancer-related deaths. The researchers investigated various types of CTCs including two that are involved in the metastasis process. The number of 'EMTed' CTCs, which had previously not been possible to capture by many other systems, was associated with poor patient survival, while the presence of 'EMTing' CTCs was closely correlated with whether the patient's cancer had become metastatic.
Using the Parsortix system, the researchers also discovered the presence of rare cells in the blood, known as 'megakaryocytes' - large bone marrow cells which produce platelets for blood clotting. Megakaryocytes have never before been linked to cancer prognosis, but the presence of these cells was found to be strongly linked to patient survival, with better outcomes for patients with greater numbers of megakaryocytes.
Lead researcher Dr Yong-Jie Lu from QMUL's Barts Cancer Institute said: "This work opens up a wide range of exciting opportunities to benefit cancer patients. We have already started to test more patient samples and will soon move on to wider clinical trials to confirm the efficacy of the test. We are also working to see if this test can be used on other types of cancer."
The team found that combining the number of 'EMTing' CTCs with the patient's 'Prostate-Specific Antigen' level (used in currently available tests) gave the best predictor of metastasis (over 92 per cent accuracy), significantly out-performing all current tests.
They also developed a combined scoring system, taking into account the numbers of both 'EMTed' CTCs and megakaryocytes harvested by the Parsortix system from a patient's blood. The scoring system was developed with 40 patients who had their disease monitored over a 20 month period, and was able to identify patients who were 10 times more likely to die from their disease in the short term.
Rebecca Porta, CEO of Orchid - Fighting Male Cancer, the main funder of the study, added: "This is a very promising study for patients and has the potential to significantly increase the ability of clinicians to act earlier to treat those who are at a higher risk of dying earlier from their cancer. Delivering more appropriate treatment more quickly could help to save lives and pro-long life expectancy."
Dr Catherine Pickworth, Cancer Research UK's science information officer, said: "Cancers spreading to new areas of the body is the main reason why people die from the disease. This study shows a potential new way of helping to monitor this spread in men with prostate cancer. It was able to predict which patients were likely to fare better than others, based on the number of a rare type of immune cell found in the blood. This may help doctors make better-informed treatment decisions based on the extra information, and ultimately improve survival."
The research was funded by Orchid - Fight Male Cancer, Cancer Research UK and ANGLE plc, developers of the ParsortixTM system. The Chinese Scholarship Council provided funding support for PhD studentships to some of the researchers.
For more information, please contact:
Joel Winston, Public Relations Manager
Queen Mary University of London
Tel: +44 (0) 207 882 7943 / +44 (0) 7970 096 188
Notes to the editor
Research paper: 'The novel association of circulating tumor cells and circulating megakaryocytes with prostate cancer prognosis'. Lei Xu, Xueying Mao, Tianyu Guo, Pui Ying Chan, Greg Shaw, John Hines, Elzbieta Stankiewicz, Yuqin Wang, Tim Oliver, Amar Ahmad, Daniel Berney, Jonathan Shamash, Yong-jie Lu. Clinical Cancer Research. doi: 10.1158/1078-0432.CCR-16-3081
URL when published: http://dx.doi.org/10.1158/1078-0432.CCR-16-3081
About Queen Mary University of London
Queen Mary University of London (QMUL) is one of the UK's leading universities, and one of the largest institutions in the University of London, with 23,120 students from more than 155 countries.
A member of the Russell Group, we work across the humanities and social sciences, medicine and dentistry, and science and engineering, with inspirational teaching directly informed by our research. In the most recent national assessment of the quality of research, we were placed ninth in the UK (REF 2014).
As well as our main site at Mile End -- which is home to one of the largest self-contained residential campuses in London -- we have campuses at Whitechapel, Charterhouse Square, and West Smithfield dedicated to the study of medicine, and a base for legal studies at Lincoln's Inn Fields.
We have a rich history in London with roots in Europe's first public hospital, St Barts; England's first medical school, The London; one of the first colleges to provide higher education to women, Westfield College; and the Victorian philanthropic project, the People's Palace at Mile End.
Today, as well as retaining these close connections to our local community, we are known for our international collaborations in both teaching and research.
QMUL has an annual turnover of £350m, a research income worth £125m (2014/15), and generates employment and output worth £700m to the UK economy each year.
ANGLE is a specialist medtech company commercialising a disruptive platform technology that can capture cells circulating in blood, such as cancer cells, even when they are as rare in number as one cell in one billion blood cells, and harvest the cells for analysis.
ANGLE's cell separation technology is called the ParsortixTM system and it enables a liquid biopsy (simple blood test) to be used to provide the cells of interest. Parsortix is the subject of granted patents in Europe, the United States, Canada, China, Japan and Australia and three extensive families of patents are being progressed worldwide. The system is based on a microfluidic device that captures live cells based on a combination of their size and compressibility. Parsortix has a CE Mark for Europe and FDA authorisation is in process for the United States.
ANGLE has established formal collaborations with world-class cancer centres. These Key Opinion Leaders are working to identify applications with medical utility (clear benefit to patients), and to secure clinical data that demonstrates that utility in patient studies. Details are available here.
The analysis of the cells that can be harvested from patient blood with ANGLE's Parsortix system has the potential to help deliver personalised cancer care offering profound improvements in clinical and health economic outcomes in the treatment and diagnosis of various forms of cancer.
The global increase in cancer to a 1 in 3 lifetime incidence is set to drive a multi-billion dollar clinical market. The Parsortix system is designed to be compatible with existing major medtech analytical platforms and to act as a companion diagnostic for major pharma in helping to identify patients that will benefit from a particular drug and then monitoring the drug's effectiveness.
As well as cancer, the Parsortix technology has the potential for deployment with several other important cell types in the future.
ANGLE stock trades on the AIM market of the London Stock Exchange under the ticker symbol AGL and in New York on the OTC-QX under the ticker symbol ANPCY. For further information please visit: http://www.angleplc.com
Orchid - Fighting Male Cancer
Orchid is the UK's leading registered charity focused exclusively on male-specific cancers. Formed in 1996 by a testicular cancer patient, Orchid exists to save men's lives from testicular, prostate, and penile cancers through pioneering research, the provision of specialist information and support, campaigns and raising awareness. For more information, please visit: http://www.orchid-cancer.org.uk
Help and Advice
Those who have concerns relating to male specific cancers can seek specialist advice and support from a team of male cancer information nurse specialists every Monday and Wednesday from 10am-5pm on the freephone Orchid Male Cancer Helpline 0808 802 0010. The Nurse Specialists can also be contacted at firstname.lastname@example.org
Every year over 50,000 men in the UK will be diagnosed with prostate, testicular and penile cancer. Of these men over 47,300 will be diagnosed with prostate cancer, over 2,300 will be diagnosed with testicular cancer and 600 will be diagnosed with the rare penile cancer. Sadly, these numbers are increasing.
For more information on Orchid, or to speak to an expert or case study, please contact: James M. Butcher, 01444 811099, James@spinkhealth.com
Clinical Cancer Research