The search for the culprit
Research network searching for minute tumour markers in the bloodstream, in order to detect cancer earlier – a total of 1.3 million euros awarded in BMBF funding.
‘If we can see the tumour, then it’s really already too late,’ says PD Dr. Georg Weber. What he means: If a tumour is large enough to be seen using imaging techniques, then a cure is virtually impossible for particularly aggressive cancers such as pancreatic cancer. Early detection Many lives could be saved if we were able to detect cancer earlier. One method of doing so is a so-called liquid biopsy. PD Dr. Georg Weber, coordinator of a new research network, is researching the role this may be able to play in cancer screening. Dr. Weber, who is a senior consultant at the Department of Surgery (Director: Prof. Dr. Robert Grützmann) at Universitätsklinikum Erlangen, hopes to identify and accurately detect tumour markers, the smallest precursors to cancer, simply by taking a blood sample. Before that is possible, however, the researchers first have to find out how to actually recognise what they are looking for.
A blood count can give you information about cholesterol levels, liver function or blood sugar. Inflammatory values or infections such as HIV can also be detected in blood samples. Will we soon be able to detect cancer in the same way? You may well have recently come across the term ‘liquid biopsy’ in the news. Several newspapers have reported that it should soon be possible to detect breast cancer very early on simply by means of a blood test. PD Dr. Weber is also researching into liquid biopsies, but he focuses on gastrointestinal tumours. Both he and Prof. Grützmann take a critical stance on the current headlines: ‘Scientific competition is fierce in cancer research. However, we mustn’t forget that new findings naturally raise patients’ hopes. Making rash promises quickly leads to disappointment,’ says the Director of the Department. ‘The fact is that many years will pass before cancer can be accurately detected in blood.’
In the new joint project carrying out research into tumour markers coordinated by PD Dr. Weber, the Department of Surgery at Universitätsklinikum Erlangen is working together with the Fraunhofer Institute for Interfacial Engineering and Biotechnology (IGB), the Center for Systems Biology, the Dana-Farber Cancer Institute (both Boston, USA) and the bioinformatics specialist Genedata. The Federal Ministry of Education and Research has provided the consortium with a total of 1.3 million euros in funding over a period of three years – 645,000 euros of which has been allocated to Erlangen.
Who is the culprit?
Using a liquid biopsy to diagnose a tumour is based on the premise that a tumour already sheds parts of the cell into the bloodstream from a very early stage. These are so specific for certain types of cancer that a doctor can detect them in a blood sample. However: How can you find something if you don’t know what it looks like? ‘That is the major challenge we are faced with,’ explains PD Dr. Weber. ‘First of all, we have to identify the tumour products such as tumour DNA or tumour exosomes circulating in the bloodstream.’
And there is another challenge. The body is predominantly healthy and the diseased tumour tissue only accounts for a minute portion. ‘Imagine a gigantic orchestra,’ explains PD Dr. Weber. Everyone is playing with all their might and the volume is quite overwhelming. Just one single violin, one single musician, is playing out of tune. We need to learn how we can hear who that is.’ An almighty task. However, the researchers in Erlangen have one major advantage: As surgeons, they are not restricted to examining blood samples, they can also investigate the tumour which is shedding the tumour by-products into the patients’ bloodstream. To follow on from the allegory given above, they can shine a spotlight onto the violinist who is playing out of tune. Comparing the ill patients to the healthy control group should allow researchers to accurately detect the differences in their blood samples.
The new research network has three goals: firstly, to identify the tumour products in the blood sample as accurately as possible. ‘It is extremely important for us that the future procedure is as sensitive and specific as possible,’ emphasises PD Dr. Weber. This is also confirmed by Prof. Dr. Matthais Beckmann, the Director of the Comprehensive Cancer Centre Erlangen-EMN: ‘In the past, patients have too often been given the wrong treatment, as the so-called ‘tumour markers’ detected in blood tests were not specific enough. New diagnosis procedures must therefore be absolutely precise and able to detect tumour components specific to certain illnesses.’ Secondly, the researchers hope to learn more about tumours themselves, how they grow, metastasise and how they change on the gene and protein level. Thirdly, the findings should be used to develop new medicines.
PD Dr. Georg Weber
Phone: +49 9131 85 33296