Imagine a test for the beginning stages of cancer – a tumor that has yet to produce any symptoms – being so simple and so inexpensive that it could be a part of a routine annual physical.
Such a test may be as little as five years away from doctors' offices across the country, says Kansas State University professor of chemistry, Stefan Bossmann.
Bossman and his partner, professor of anatomy and physiology Deryl Troyer, have successfully and accurately detected the beginning states of breast cancer and non-small-cell lung cancer in a small group of test patients.
Their test, which provides results in less than an hour, relies on detecting the enzymes that all solid-tumor cancers must produce in order to grow.
"Solid-tumor cancers must interact with the blood stream in order to attract the nutrients they need," Bossman said. "They produce enzymes to attract those nutrients. The test we have developed is able to identify those enzymes if they are present."
Bossman and Troyer are affiliated with Kansas State University's Johnson Cancer Research Center and the University of Kansas Cancer Center.
Tests detecting for pancreatic cancer are anticipated to begin within a week as part of Bossmann and Troyer's collaboration with Dr. Stephen Williamson at the University of Kansas Medical Center. Blood samples from triple-negative breast cancer patients will be tested this fall in collaboration with Dr. Priyanka Sharma, who is also at the University of Kansas Medical Center.
Bossman said he is hopeful that testing for other hard to detect cancers will quickly follow.
"Right now, the only thing holding us back is the need for assuring the test works on a larger number of patients," he said. "We are beginning the process of testing hundreds or thousands of patients to verify that the 95% accuracy we saw with our small sample will hold up."
He said the technology to produce large numbers of tests at a reasonable cost is already in place.
"The ability to do this a low cost is key," Bossman said. "It does no good to have a test that is so costly that nobody can afford to use it."
Bossmann and Troyer's test uses iron nanoparticles coated with amino acids and a dye, which are introduced to small amounts of blood or urine from a patient. The amino acids and dye interact with enzymes in the patient's urine or blood sample. Each type of cancer produces a specific enzyme pattern, or signature, that can be identified by doctors.
"These enzyme patterns can also help distinguish between cancer and an infection or other diseases that commonly occur in the human body," Bossmann said. "For example, a person who smokes a lot of cigars may develop an inflammation in their lungs. That will drive up some of the markers in the test but not all of them. Doctors will be able to see whether there was too much smoke inhalation or if there is something more serious going on. False-positives are something that we really want to avoid."
Bossmann and Troyer have designed a second testing method that is anticipated to produce the same results in about five minutes. The team recently received $305,000 in funding for this project from the National Science Foundation's Division of Chemical, Bioengineering, Environmental and Transport Systems.
Gary Gadbury, professor of statistics at Kansas State University, helped analyze the data from tests with lung and breast cancer patients. The results, data and analysis were recently submitted to the Kansas Bio Authority for accelerated testing.
"We see this as the first step into a new arena of investigation that could eventually lead to improved early detection of human cancers," Troyer said. "Right now the people who could benefit the most are those classified as at-risk for cancer, such as heavy smokers and people who have a family history of cancer. The idea is these at-risk groups could go to their physician's office quarterly or once a year, take an easy-to-do, noninvasive test, and be told early on whether cancer has possibly developed."
The researchers say the test would be repeated a short time later. If cancer is confirmed, diagnostic imaging could begin that would otherwise not be routinely pursued.
Catching the problem early
According to the American Cancer Society, an estimated 39,920 breast cancer deaths and 160,340 lung cancer deaths are expected in the U.S. in 2012.
With the exception of breast cancer, most types of cancer can be categorized in four stages based on tumor growth and the spread of cancer cells throughout the body. Breast and lung cancer are typically found and diagnosed in stage 2, the stage when people often begin exhibiting symptoms such as pain, fatigue and coughing. Numerous studies show that the earlier cancer is detected, the greater chance a person has against the disease.
"The problem, though, is that nobody knows they're in stage 1," Bossmann said. "There is often not a red flag to warn that something is wrong. Meanwhile, the person is losing critical time."
In addition to early detection, researchers say the test can be tweaked to monitor cancer. For example, patients being treated with drugs can be observed for drug effectiveness. Similarly, doctors can use the dye in the test to determine if the entirety of a tumor has been successfully removed from a patient after surgery.
Researchers evaluated the test's accuracy on 32 separate participants in various stages of breast or lung cancer. Data was collected from 20 people with breast cancer -- ranging in age from 36 to 81 years old -- and 12 people with lung cancer -- ranging in age from 27 to 63 years old.
Twelve people without cancer were also tested as a control group. This group ranged in age from 26 to 62 years old.
A blood sample from each participant was tested three times. Analysis of the data showed a 95% success rate in detecting cancer in participants, including those with breast cancer in stages 0 and 1 and those with lung cancer in stages 1 and 2.
Funding for the study -- titled "Functionalized Bimagnetic Core/Shell Fe/FE3O4 Stealth Nanoparticles for Diag & Treatment Cancer" -- was originally provided through a subcontract of a National Institutes of Health phase II Small Business Innovation Research grant to NanoScale Corp., a Manhattan-based company that manufactures, markets and commercializes advanced products and technologies, and by the Johnson Cancer Research Center at Kansas State University. A Small Business Innovation Research grant is awarded to small businesses with a university partner for the purpose of accelerating research to enter the commercial marketplace.