scholarly journals The Role of “Liquid Biopsy” Repositories in Cancer Care in Low to Middle–Income Countries

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 244s-244s
Author(s):  
M. Kohli
Keyword(s):  
Cancer Patients ◽  
Whole Blood ◽  
Cancer Care ◽  
Liquid Biopsy ◽  
Healthcare Delivery ◽  
Cancer Center ◽  
Cell Free Dna ◽  
Middle Income ◽  
Middle Income Countries ◽  
Free Dna

Background and context: Translation of underlying individual genomic heterogeneity in cancer into precision medicine practice requires annotated cancer biorepositories. The potential for practice of precise medicine is also coupled to saving vital resources in low to middle–income countries. An overview of experience and outcomes from a tertiary level cancer center in a high-income country for liquid biobank established since 2009 is presented. Aim: To understand the challenges of building economically viable biorepositories that can be used for molecular diagnostics while delivering cancer care. Strategy/Tactics: An institutional ethics–approved prospective liquid biorepository was established in September of 2009 for advanced cancer patients. Informed consent–approved collection of 29.5 mL blood/urine was performed serially on enrolled patients and clinical annotation was obtained during follow-up including previous, current and future treatments and their outcomes. All specimens were processed using a uniform protocol in which extraction of germline DNA from buffy coats; serum for proteomics; platelet-poor and platelet-rich plasma (in citrate and EDTA anticoagulants) for microRNA and cell-free DNA extractions; and extraction of PAXgene RNA/DNA from whole blood was performed. Processing was done within 45 minutes of sample acquisition and storage in −80°C freezers with no freeze–thaw cycles. Program/Policy process: Biobanking for cancer care. Outcomes: Between September of 2009 and January of 2015, 535 advanced-stage prostate cancer patients in hormone-sensitive and castrate-resistant stage; 250 advanced kidney cancer patients; 110 testicular cancer patients were enrolled and 1550 collections were performed serially. This generated >60,000 plasma/serum/DNA/RNA aliquots. Nucleic acids (DNA/RNA) from buffy coats and whole blood of 500-1000 ng volume each were also extracted. Cell-free DNA for somatic mutational and copy number analysis; single nucleotide profiling from germline DNA; RNA expression profiling from whole blood and microRNA analysis in plasma has been performed from this cohort along with proteomics using tandem mass spectrometry. By 2017, this has resulted in >35 scientific publications; 5 patents; multiple national and international grant awards and enhanced precision cancer care for patient care. The cost burden for establishing the infrastructure was highly economical. What was learned: In our experience, liquid biopsy repositories can augment clinical cancer globally, but do not find this discussed in low to middle–income nations. Advancing and applying molecular oncology and team science to prospectively collected and retrospectively annotated biobanks can be a cost-efficient resource in a global cancer healthcare delivery system and a useful tool for scientific and economic opportunities and collaborations.

scholarly journals Triaging and adaptations of surveillance of cancer services in the COVID pandemic

2020 ◽  
pp. 1-3
Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan
Keyword(s):  
Cancer Patients ◽  
Clinical Examination ◽  
Cancer Care ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Cancer Services ◽  
Low Middle Income Countries

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.

Potential clinical applications of circulating cell-free DNA in ovarian cancer patients

2018 ◽  
Vol 20 ◽  
Author(s):  
Ana Barbosa ◽  
Ana Peixoto ◽  
Pedro Pinto ◽  
Manuela Pinheiro ◽  
Manuel R. Teixeira
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Liquid Biopsy ◽  
Clinical Applications ◽  
Epigenetic Alterations ◽  
Cell Free Dna ◽  
Non Invasive ◽  
Free Dna ◽  
Potential Use ◽  
Circulating Cell Free Dna

AbstractCirculating cell-free DNA (cfDNA) consists of small fragments of DNA that circulate freely in the bloodstream. In cancer patients, a fraction of cfDNA is derived from tumour cells, therefore containing the same genetic and epigenetic alterations, and is termed circulating cell-free tumour DNA. The potential use of cfDNA, the so-called ‘liquid biopsy’, as a non-invasive cancer biomarker has recently received a lot of attention. The present review will focus on studies concerning the potential clinical applications of cfDNA in ovarian cancer patients.

scholarly journals Psychological Support and Telehealth Options for Patients with Cancer during the Covid-19 Pandemic in Saudi Arabia

2021 ◽  
Vol 8 ◽  
Author(s):  
Manal Banaser ◽  
Sami Alshammary
Keyword(s):  
Cancer Patients ◽  
Support Groups ◽  
Cancer Care ◽  
Healthcare Delivery ◽  
Psychosocial Care ◽  
Multidisciplinary Care ◽  
Psychological Support ◽  
Registry Data ◽  
Cancer Center ◽  
Healthcare Delivery System

Background: COVID-19 concerns are associated with an increase in symptoms of depression and anxiety among cancer patients. Telehealth services hold incredible potential for providing psychological support to cancer patients. In a technology-assisted intervention for telehealth, hotline services are a valuable tool to provide psychosocial care. This paper examines the use of hotline services to offer psychological support to cancer patients. Methods: A retrospective analysis of hotline calls patient registry data was conducted. Data were collected from a single cancer center in Riyadh, from May 2020 to March 2021, with a random sample of 877 callers to cancer hotline services. Responses of a satisfaction questionnaire were linked to call-related concerns of registry data.  Results: A total of 877 calls were received, the majority of which came from Riyadh locals. Patient disease complaints accounted for 210 calls (24%), while retake medicine requests accounted for 251 calls (28.62%). 143 (16.31%) calls were about scheduled new appointments, 261 calls (29.76%) were about psychological issues induced by Covid-19, such as worry, fear, and anxiety symptoms, and 12 calls (1.37%) having to do with Covid-19. Seven hundred seventy-two callers (88 %) indicated satisfaction with the services call attended. Discussion: Hotline services in cancer care have been identified as a key resource telehealth service that positively influences patient satisfaction and meets cancer patient needs in the face of the pandemic. This study also highlighted the need for other telehealth services, such as mental health mobile applications, virtual multidisciplinary care, and online support groups, which can provide an excellent option for providing psychological support to cancer patients. Conclusion: This study found that providing Cancer Care Hotline services during a pandemic improves patient-centered care and a more efficient healthcare delivery system. 

scholarly journals Nanopore sequencing from liquid biopsy: analysis of copy number variations from cell-free DNA of lung cancer patients

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Filippo Martignano ◽  
Uday Munagala ◽  
Stefania Crucitta ◽  
Alessandra Mingrino ◽  
Roberto Semeraro ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Liquid Biopsy ◽  
Copy Number ◽  
Dna Analysis ◽  
Copy Number Variations ◽  
Nanopore Sequencing ◽  
Cell Free Dna ◽  
Lung Cancer Patients ◽  
Free Dna

AbstractIn the “precision oncology” era the characterization of tumor genetic features is a pivotal step in cancer patients’ management. Liquid biopsy approaches, such as analysis of cell-free DNA from plasma, represent a powerful and noninvasive strategy to obtain information about the genomic status of the tumor. Sequencing-based analyses of cell-free DNA, currently performed with second generation sequencers, are extremely powerful but poorly scalable and not always accessible also due to instrumentation costs. Third generation sequencing platforms, such as Nanopore sequencers, aim at overcoming these obstacles but, unfortunately, are not designed for cell-free DNA analysis.Here we present a customized workflow to exploit low-coverage Nanopore sequencing for the detection of copy number variations from plasma of cancer patients. Whole genome molecular karyotypes of 6 lung cancer patients and 4 healthy subjects were successfully produced with as few as 2 million reads, and common lung-related copy number alterations were readily detected.This is the first successful use of Nanopore sequencing for copy number profiling from plasma DNA. In this context, Nanopore represents a reliable alternative to Illumina sequencing, with the advantages of minute instrumentation costs and extremely short analysis time.The availability of protocols for Nanopore-based cell-free DNA analysis will make this analysis finally accessible, exploiting the full potential of liquid biopsy both for research and clinical purposes.

scholarly journals Cell-free DNA analysis in current cancer clinical trials: a review

2022 ◽  
Author(s):  
M. Cisneros-Villanueva ◽  
L. Hidalgo-Pérez ◽  
M. Rios-Romero ◽  
A. Cedro-Tanda ◽  
C. A. Ruiz-Villavicencio ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cancer Patients ◽  
Liquid Biopsy ◽  
Dna Analysis ◽  
Therapy Resistance ◽  
Cell Free Dna ◽  
Free Dna ◽  
Technical Validation ◽  
Ctdna Analysis

AbstractCell-free DNA (cfDNA) analysis represents a promising method for the diagnosis, treatment selection and clinical follow-up of cancer patients. Although its general methodological feasibility and usefulness has been demonstrated, several issues related to standardisation and technical validation must be addressed for its routine clinical application in cancer. In this regard, most cfDNA clinical applications are still limited to clinical trials, proving its value in several settings. In this paper, we review the current clinical trials involving cfDNA/ctDNA analysis and highlight those where it has been useful for patient stratification, treatment follow-up or development of novel approaches for early diagnosis. Our query included clinical trials, including the terms ‘cfDNA’, ‘ctDNA’, ‘liquid biopsy’ AND ‘cancer OR neoplasm’ in the FDA and EMA public databases. We identified 1370 clinical trials (FDA = 1129, EMA = 241) involving liquid-biopsy analysis in cancer. These clinical trials show promising results for the early detection of cancer and confirm cfDNA as a tool for real-time monitoring of acquired therapy resistance, accurate disease-progression surveillance and improvement of treatment, situations that result in a better quality of life and extended overall survival for cancer patients.

scholarly journals Clonal Hematopoiesis in Lung Cancer and Its Impact on Liquid Biopsy Based on Targeted Deep Sequencing

2021 ◽  
Author(s):  
Yang Xue ◽  
Youyu Wang ◽  
Yingmei Li ◽  
Danni Liu ◽  
Mengqi Shao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Liquid Biopsy ◽  
Detection Rate ◽  
Low Frequency ◽  
Cell Free Dna ◽  
High Background ◽  
Lung Cancer Patients ◽  
Clonal Hematopoiesis ◽  
Free Dna

Abstract Background: Blood based liquid biopsy has proved its potential in enormous clinical applications, such as cancer screening, diagnosis, treatment guidance, disease tracking and monitoring. In certain scenario (e.g., molecular residual disease), it requires the technique to be able to detect mutation with very low frequency (0.001% ~ 1%). The major hurdle of ultra-sensitive circulating tumor DNA sequencing is the high background noise of plasma cell-free DNA (cfDNA) and clonal hematopoiesis (CH). Here in this study, we investigated the prevalence of CH in lung cancer patients and its interference with liquid biopsy. Methods: We retrospectively analyzed cfDNA and blood cell genomic DNA (gDNA) sequencing data sets (n=1261) from a group of Chinese lung cancer patients. Threshold (1%) and subthreshold (0.2%) for variant allele frequency were set and compared. We focused on 23 clonal hematopoiesis genes that were selected based on previous publications. Results: CH mutations were detected in 27.68% of all the patients at the threshold and 62.01% at the subthreshold, and the detection rate increased with age. DNMT3A was the most frequently mutated CH gene, accounted for more than half of the CH mutations. The CH mutations had a higher detection rate in smokers (72%) than non-smokers (59.4%) at subthreshold. VAFs of CH mutations in cell-free DNA strongly correlated with their VAFs in gDNA (Pearson’s R =0.92, p<2.2x10-16), while tumor derived somatic mutations didn’t have such correlation. Conclusion: Our study showed that clonal hematopoiesis is very common in lung cancer patients, especially when examining low frequency mutations. Sequencing of gDNA at equivalent depth is very important to filter out CH mutation in cancer liquid biopsy.

Cell free DNA as an evolving liquid biopsy biomarker for initial diagnosis and therapeutic nursing in Cancer- An evolving aspect in Medical Biotechnology

2020 ◽  
Vol 21 ◽  
Author(s):  
Suman Kumar Ray ◽  
Sukhes Mukherjee
Keyword(s):  
Tumor Cells ◽  
Liquid Biopsy ◽  
Cancer Metastasis ◽  
Nuclear Dna ◽  
Fragment Size ◽  
Body Fluids ◽  
Response To Therapy ◽  
Significant Information ◽  
Cell Free Dna ◽  
Free Dna

: Cell-free DNA (cfDNA) is present in numerous body fluids in addition to initiates generally from blood cells. It is undoubtedly the utmost promising tool among all components of liquid biopsy. Liquid biopsy is a specialized method investigating the nonsolid biological tissue by revealing of circulating cells, cell free DNA etc. that enter body fluids. Since, cancer cells disengage from compact tumors circulate in peripheral blood, evaluating blood of cancer patients holds the opportunities for capture and molecular level analysis of various tumor-derived constituents. Cell free DNA samples can deliver a significant perceptions into oncology, for instance tumor heterogeneity, instantaneous tumor development, response to therapy and treatment, comprising immunotherapy and mechanisms of cancer metastasis. Malignant growth at any phase can outhouse tumor cells in addition to fragments of neoplasticity causing DNA into circulatory system giving noble sign of mutation in the tumor at sampling time. Liquid biopsy distinguishes diverse blood based evolving biomarkers comprising circulating tumor cells (CTCs), circulating tumor DNA (ctDNA) or cfDNA, circulating RNA (cfRNA) and exosomes. Cell free DNA are little DNA fragments found circulating in plasma or serum, just as other fluids present in our body. Cell free DNA involves primarily double stranded nuclear DNA and mitochondrial DNA, present both on a surface level and in the lumen of vesicles. The probable origins of the tumor-inferred portion of cfDNA are apoptosis or tumor necrosis, lysis of CTCs or release of DNA from the tumor cells into circulation. The evolution of innovations, refinement and improvement in therapeutics for determination of cfDNA fragment size and its distribution provide significant information related with pathological conditions of the cell, thus emerging as promising indicator for clinical output in medical biotechnology.

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