Cianna Medical, based in Aliso Viejo, CA, won FDA clearance for its SAVI SCOUT wire-free technology to be used for localizing of soft tissues. Previously, in the U.S. the SCOUT has only been indicated for use in localizing breast tumors (see flashbacks below).
“SCOUT resolves one of the most difficult aspects of breast cancer treatment by allowing us to accurately localize soft tissue such as axillary lymph nodes,” said Ari Brooks, surgical breast oncologist and Director of the Integrated Breast Center at Penn Medicine, in a published statement. “The SCOUT reflector is very well suited for use in the lymph nodes.”
The SCOUT implant doesn’t emit any dangerous radiation and finding it doesn’t require ionizing radiation either from the localizer. It can be implanted days before surgery, giving flexibility in scheduling biopsies and surgical excision.
Being able to monitor the chemical content of cancer cells may help scientists develop new anti-cancer medications. Additionally, it may also lead to personalized drug therapies for cancer patients that all too often end up trying multiple medications before finding one that works. Chemists at MIT have come up with just such a tool for so-called redox medications, which are drugs that aim to increase hydrogen peroxide (H2O2) concentrations inside of cancer cells.
Redox drugs can either promote the production of H2O2, or they act to reduce the production of antioxidants that help to rescue cells from high levels of H2O2. In clinical studies, redox drugs have tended to work better on some people than on others, probably because of the unique differences of each patient’s tumor.
The MIT team, in order to better understand redox drugs and how they work on different cancers, tinkered with the peroxiredoxin protein, a molecule that can detect changes in H2O2 levels, adding two fluorescent proteins to it. One of the proteins fluoresces green, and is attached at one end of the peroxiredoxin, while the other produces a red color and is attached at the opposite end of the peroxiredoxin molecule.
When this new molecule interacts with hydrogen peroxide, its shape changes, and the two fluorescent tips move closer or farther away from each other. This shift can be detected by sensing a color change when the molecule is forced to fluoresce before and after the reaction.
Immuno-oncology, a rapidly developing field that harnesses the body’s immune system to attack cancers, lacks effective methods of testing potential therapies. In addition to animal studies, tiny bits of tumors are placed, along with chemical compounds being tested, within multiwell plates and watched over using a number of techniques. While this has allowed the field of immuno-oncology to progress quite well, the tumor fragments being tested don’t survive for long on their own, the complexity of the actual tumor is not well represented, and how the immune cells interact with the tumor can’t be controlled.
Researchers at Draper, a research and development firm, have created a microfluidic device that is able to catch tumor fragments and expose them to different immunotherapies while more closely replicating the tumor’s natural environment.
The device, called EVIDENT (Ex Vivo Immuno-oncology Dynamic ENvironment of Tumor biopsies), consists of a dozen channels, which can be expanded to many more in future versions. Each channel has a set of pegs that trap tumor fragments passing through. Once the tumors are positioned against the pegs, specially developed white blood cells can be fed through the channels so they land onto the tumor’s surface.
Other cells and chemicals can also be added to the microchannels, and the concentrations of these additions can be made to change over time to simulate different environments.
Draper researchers, working with others from Merck, have already tested the device with very promising results.
Researchers from Harvard and MIT have developed microparticles that can treat a specific genetic subtype of glioma, a brain cancer. The microparticles slowly release a drug that specifically targets cancer cells that rely on a particular enzyme. During surgery to remove the brain tumor, clinicians can conduct a rapid (30 min) genetic test on a biopsy sample to see if the tumor is suitable for treatment. If so, they can place the microparticles into the resection site to kill cancer cells at the resection boundary and help to prevent tumor recurrence.
Removing an entire brain tumor can be tricky, especially if it is located near an area of the brain responsible for vital tasks, such as movement or speech. Sometimes this means that surgeons cannot remove the whole tumor, and in many cases it can recur. The Boston-based researchers wanted to develop a tumor-specific treatment that surgeons could place at the resection site, which would help to kill any remaining cancer cells.
The team decided to target a subtype of glioma (present in 25% of patients), in which a specific mutation means that the cancer cells are reliant on a particular enzyme. Drugs that can inhibit this enzyme and kill the cancer cells are available, but they have significant side-effects elsewhere in the body, and cannot easily cross the blood-brain barrier to reach the tumor.
Electron microscopy image of the new drug-delivery system.
To address this, the researchers created a microparticle delivery vehicle that can release the drug directly at the resection site. They used PLGA, a polymer that can release the drug over a sustained period, to make microparticles that can be inserted directly into the brain. By altering the composition of PLGA, the researchers could tune how quickly the drug was released.
So far, the researchers have tested the microparticles in mice, and found that the treatment extended the life of the animals with treatment-susceptible tumors, without any of the harmful side-effects seen if the drug is used systemically. The research team is interested in expanding the system to target other genetic susceptibilities present in gliomas and other brain cancers.
Patients with glioblastoma, a persistent and difficult to treat brain cancer, often end up suffering through multiple rounds of chemo and radiation therapy. Scientists at MIT have been working on harnessing the power of artificial intelligence to better optimize the therapy dosages, sparing the patients the brunt of the treatments while maintaining their clinical effectiveness.
Their software, which uses a technique called reinforced learning, assesses different data points about a given patient, and uses information obtained from thousand of previous similar cases to produce a treatment plan that is better optimized than existing regimens. So far the technology has been tested in silico on virtual patients, pointing to significant reductions in dosage levels while maintaining the ability to reduce the size of tumors. In the 50 “patients” that were “treated” using the technology, the dosage levels were frequently reduced by half or more, and therapy sessions were often significantly reduced in their frequency. “We kept the goal, where we have to help patients by reducing tumor sizes but, at the same time, we want to make sure the quality of life — the dosing toxicity — doesn’t lead to overwhelming sickness and harmful side effects,” said Pratik Shah, a leader of the research.
The reinforced learning technique relies on virtual agents that attempt to complete different tasks in order to meet a goal. The closer to the goal the agent gets to, the greater the reward it receives. The agent learns from these rewards and adjusts its actions to maximize future rewards. Because this is done within a computer and can be performed thousands of times, the agents eventually produce better and better predictions of what actions should be taken.
Biopsies and bronchoscopies are the gold standard for diagnosing lung diseases, including pneumonia and cancer. However, these procedures are difficult to provide, requiring general anesthesia and an operating room. Deton hopes to simplify the process.
The Pasadena-based company takes advantage of the lung’s natural reaction to bacteria or particles — coughing it out. Rather than invasively sampling lung tissue within the lungs, Deton’s patented technology samples the particles ejected from the lungs. The expelled cough sample is then read by a point-of-care analyzer or sent to a lab.
“When a person coughs, it’s the body’s natural way of expelling any extra bacteria in the lungs,” Co-Founder and COO Ramzi Nasr points out. “Any DNA can come out… so it makes sense to use this mechanism and leverage that when we’re trying to access the lung non-invasively.”
Patrick Sislian, Co-Founder and CEO, says that the technology has two key advantages over traditional bronchoscopy and biopsy: it’s much quicker and less expensive. For instance, the exact bacterial species causing a case of pneumonia could be identified using a point-of-care test rather than waiting to see a pulmonologist, reducing the time spent on empiric antibiotics that may or may not work for that particular infection. “It takes about 10 minutes to obtain a sample,” Sislian says. As a result, the patient can receive tailored antibiotics within hours rather than days. “You’re saving the patient trouble, and you’re saving the system money.”
Another important use case is lung cancer, the leading cause of cancer deaths in the United States. If a CT scan shows a suspicious lung nodule, the current protocol is to wait a few months, repeat the CT scan, and obtain a lung biopsy if the mass has enlarged. Deton’s goal is that an aerosol biopsy could be obtained immediately after seeing the first CT scan, either detecting cancerous cells or ruling out lung cancer months earlier than before.
So far, the technology has been tested in patients with cystic fibrosis, a disease that causes recurrent lung infections. In a sample of a hundred patients from the University of California, San Diego, the company’s aerosol biopsy showed 94% sensitivity in detecting Pseudomonas, one of the major bacterial causes of pneumonia in cystic fibrosis.
While more research and fine-tuning will be needed before the aerosol biopsy is used in hospitals, the company aims to commercialize its technology for lung research use within the next two years. “The lungs are very difficult to access without invasive methods,” Nasr points out. “It’s very hard to recruit a healthy control baseline of subjects that are willing to be in a study where [samples] are going to be invasively collected from the lungs.” As such, Deton aims to fill a major need in lung research.
Since idea conception in 2012 and the first commercialization efforts in 2016, the company has moved quickly, raising $1.8 million in government grants and investments and is in the process of raising a $2 million seed round.
Sislian acknowledges the skepticism that some might have about the aerosol biopsies. “The key to overcoming [that] is data,” he says. “So we want to build our data, and we’re very conscious about having data to back us up every step of the way.” With more data in hand, Deton hopes to replace traditional lung biopsies and bronchoscopies with something much more efficient, less expensive, and less invasive.
Researchers at Washington University in St. Louis have developed a new method to bypass the blood-brain barrier and deliver drugs to the brain, which could be particularly useful in difficult-to-treat brain tumors. The technique involves administering drugs through an intranasal spray, meaning that the drug can travel directly into the brain along the trigeminal and olfactory nerves. Then, the researchers can use focused ultrasound to allow the drug to penetrate and accumulate in deeper layers of the tissue, and exert therapeutic benefit at the ultrasound-targeted region.
Drug therapy for brain tumors is challenging, because the blood-brain barrier makes it difficult for drugs to penetrate the blood vessels that line the brain. To address this, this research group thought about a different route of delivery, through the nerves in the nose, that could bypass the blood-brain barrier.
“At the beginning, I couldn’t even believe this could work,” said Hong Chen, a researcher involved in the study. “I thought our brains are fully protected. But these nerves actually directly connect with the brain and provide direct access to the brain.”
The researchers developed a method to target the drug to specific brain regions, once it is in the brain. The method involves a patient using an intranasal spray to deliver a drug to the nerves that are present in the nasal cavity, which then transport the drug directly into the perivascular space in the brain.
The researchers can then target intravenously injected microbubbles (which could be injected into a blood vessel elsewhere, such as in the arm, for example), using focused ultrasound at the brain region they wish to treat. The ultrasound causes the microbubbles to oscillate, which expands and contracts the blood vessels and the perivascular space surrounding the blood vessels. This allows the drug to penetrate through the perivascular space, resulting in local accumulation of the drug at the ultrasound-targeted region.
So far, the researchers have tested the technique in mice but aim to optimize it further to assess its potential in treating diffuse intrinsic pontine gliomas, a childhood cancer with limited treatment options.
The cells of triple negative breast cancer tumors don’t have receptors for estrogen, progesterone, and HER2, the main targets used to attack breast cancers. This is why they’re so difficult to treat, but researchers at George Washington University have shown that a technique of delivering a chemotherapy agent within specially designed nanoparticles can be very powerful against these triple negative breast cancers.
The team, after much trial and error, concocted a formulation of the nanoparticles so as to have the greatest effects on the human cancer lines they worked with. Turns out the smallest nanoparticles that are designed to have the slowest release of the doxorubicin, the drug that was studied, had the most powerful killing effect.
Of course the nanoparticles will next have to be tried in lab animals before going further into clinical trials, which will surely take quite a few years.
Researchers at the University of Pennsylvania’s School of Medicine have developed a new method for sequencing chemical groups attached to the surface of DNA. These chemical groups are modifications of the DNA bases that convey important information relating to the patterns of gene expression. These modifications have been studied for the past two decades and are now known to be involved in the development of a variety of diseases, including cancer, making the identification of these modifications a promising tool for diagnostic and prognostic purposes.
Traditional methods for deciphering this epigenetic code have utilized bisulfite because of its advantageous selective chemical reactivity, however the use of bisulfite has many limitations. One of the main issues with using bisulfite-based methods is that it can destroy much of the sample during experimentation. This makes the investigation of specific cell types or rare cell populations much more challenging. To address this issue, the method proposed by the group at the University of Pennsylvania, instead makes use of a class of immune-defense enzymes called APOBEC DNA deaminases. These deaminase enzymes can achieve the same effect as bisulfite without degrading the sample. In their paper published in Nature Biotechnologydetailing their method, the team demonstrated that they required a DNA sample 1,000 times smaller in their method than in bisulfite-based methods to determine the epigenetic code of one type of neuron.
The team members hope that their new method will provide opportunities to study the epigenetic code of DNA from small and rare populations of cells and yield further insight into the mechanisms underlying the involvement of these cells in disease. “This technological advance paves the way to better understand complex biological processes such as how the nervous system develops or how a tumor progresses,” said co-senior author Hao Wu, PhD. Future work will be required to develop other schemes integrating APOBEC to further advance its identification capabilities.
At the American Society for Radiation Oncology annual meeting, Siemens Healthineers has unveiled its RT Pro edition for Biograph Vision PET/CT scanner and MAGNETOM Sola 1.5 Tesla MRI machine to help with radiation therapy planning. Both systems are specifically designed to aid in planning of radiotherapy procedures and each features some major improvements over previous devices.
The RT Pro Edition for Biograph Vision PET/CT comes with a brand new detector that has the highest available sensitivity characteristics and produces higher image resolutions. Its 78 cm bore lets large bodies slide in and out and allows for various positioning and navigation accessories to be placed inside with the patient. The system has a host of features dedicated to respiratory gating to get rid of motion artifacts when breathing and to match up the CT and PET signals accurately.
The MAGNETOM RT Pro edition for MAGNETOM Sola sports a new magnet and the technical architecture to drive it. Features include image stabilization, anti-distortion capabilities, automatic axial image reconstruction for processing of data in radiation therapy planning software.
The MRI can be interfaced with positioning lasers to make sure alignments are just about perfect.Software for the device allows to create synthetic computed tomography (CT) images made from MR images, in many cases avoiding having to have patients also get CT scans.