One of the biggest obstacles to translating research is forging relationships with the right partners. A new Cancer Moonshot initiative will begin to pave a trail to overcome this obstacle, bringing together government, academic and industry partners to accelerate development of liquid biopsy tests for cancer.
The idea behind a liquid biopsy is to analyze the cancer cells or molecules cancers release that circulate within the bloodstream. Through a blood test, doctors may be able to improve how they diagnose cancer or personalize recommended treatments.
The Cancer Moonshot's Blood Profiling Atlas will aggregate raw datasets from circulating tumor cells, circulating DNA and other assays. These large pools of data will be freely available to qualified researchers. The project will also involve sharing sample preparation and handling protocols from multiple different groups to create best practices and standards.
As one of 20 institutions to participate in the initiative, University of Michigan Rogel Cancer Center researchers will share data from patient blood samples that have been analyzed, including circulating tumor cell data and genetic sequencing of DNA and RNA. The U-M team will also share standard operating procedures for collecting and processing blood specimens for liquid biopsy analysis.
Muneesh Tewari, M.D., Ph.D., will coordinate with other U-M researchers on this effort.
"I see this as a beginning. It has potential to stimulate greater movement toward working collaboratively across industries to find real solutions for patients," says Tewari, co-director of the Rogel Cancer Center's Translational and Clinical Research Program.
He discusses the new initiative below.
How might the Blood Profiling Atlas help move this research forward?
Tewari: There have been some very exciting developments in the past few years using new types of blood tests to provide better monitoring and more individualized therapies for cancer patients. There's a lot of potential opportunity for this to advance cancer care. The Moonshot Blood Profiling Atlas will help accelerate this progress and the development of these new approaches.
In the first phase, it's about sharing data more openly and more publicly. The Blood Profiling Atlas will be a public resource for research data related to this topic, getting this information more quickly into the public domain where everyone can access it. By sharing data and best practices, we can move the research forward faster.
This type of public-access data sharing involving both industry and academia is unusual. A lot of data doesn't get out there. Companies don't necessarily share their data and even in academia, the raw data is often not broadly accessible. Although results get published in academic journals, often that's just a subset of analyzed data, not the full primary dataset. The idea here is to create something that's publicly accessible in one place so everyone working to advance liquid biopsy approaches can access it.
Even a little bit of the kind of coordination proposed by the Moonshot could go a long way in terms of translating findings into real solutions to improve patient outcomes.Muneesh Tewari, M.D., Ph.D.
Why combine government, academic, pharmaceutical and diagnostic companies?
Tewari: This kind of partnership is especially important to applied research or translational research. The process of taking research findings from basic science labs and applying them to create solutions that will help patients is very complex. There are so many moving parts, so many stakeholders and so many elements involved.
It requires coordination. The more you can get different stakeholders working together from the beginning, things are going to move faster. Research too often happens in silos. Even a little bit of the kind of coordination proposed by the Moonshot could go a long way in terms of translating findings into real solutions to improve patient outcomes.
If this research is translated, how do you think liquid biopsies could improve outcomes for patients with cancer?
Tewari: The hope in this field is that it will allow patients to get the right treatment at the right time by performing a genetic analysis of a tumor through a blood sample.
Patients will likely still need that initial tissue biopsy to establish their diagnosis. But during the patient's journey through treatment, liquid biopsies might be able to take the place of additional tissue biopsies and allow the treatment to be adapted as the tumor changes.
We are already seeing how circulating tumor cells and circulating tumor DNA can show how the tumor is evolving throughout treatment. We can alter the treatment plan in real time based on the markers we see that day. This can be very individualized for each patient. That's already beginning to happen.
What kind of work have you and others at the University of Michigan done previously in this area that will contribute to this initiative?
Tewari: Dan Hayes, M.D., has been a pioneer in the circulating tumor cell field. He and his team have continued to push the limits of all the information you can glean from the tumor cells found in patients' blood.
Scott Tomlins, M.D., Ph.D., is collaborating with Todd Morgan, M.D., on taking all the exciting new circulating DNA sequencing technology and finding ways to make it practical and useful in the clinic. How do we reduce turnaround time and lower the cost while still getting useful information that guides treatment? They have already done a lot of this work with tissue samples, and they are now developing ways to apply this to blood samples in a practical and more cost-effective way.
My lab has focused on developing and applying new approaches to sequence DNA that is released by tumors into the bloodstream. We're also looking at this for RNA released by tumor cells into the bloodstream. We have funding from the National Institutes of Health to develop sequencing of circulating RNA as a new approach for blood profiling. The idea is that RNA can give us different kinds of information that can complement what we learn from circulating DNA. RNA is expected to be more dynamic, changing quickly as the tumor changes.
We are also studying how to best collect and process samples for circulating DNA profiling. This turns out to be really important for producing reliable and reproducible results.
There's a lot of promise in this work. We're excited to be part of the national effort.