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J&J Blood test for cancer gets US boost
  By Kerry Sheridan (AFP) - 6 hours ago
WASHINGTON - Pharmaceutical giant Johnson & Johnson said Monday it is partnering with US doctors to improve a blood test for cancer that could do away with biopsies and transform the field of cancer treatment.
The Circulating Tumor Cell (CTC) microchip technology, which inventors describe as a "liquid biopsy," has been touted as a revolutionary approach to diagnosing cancer since it was first developed several years ago by doctors at Massachusetts General Hospital.
It works by detecting cancer cells that have detached from a tumor and are circulating at very low levels in the blood.
But until now, the technology has been unable to do much more than count cells, giving doctors an idea of what is happening with a patient's cancer but not delivering the precision that the latest version can.
"The new technology allows us to not just count them but to understand the molecular changes that lead to the disease progression that is occurring in the cells," said Nicholas Dracopoli, vice president of Ortho Biotech Oncology Research and Development (ORD), a unit of Johnson & Johnson.
With just a single blood draw, the new technology can give researchers access to cells from a patient's tumor, without the patient having to undergo invasive and often painful surgical biopsy procedures.
"And that will then allow us to do sophisticated molecular analysis of those isolated cells so that we can then look and see if there are therapies that are optimally suited to a patient with those particular abnormalities," Dracopoli told AFP.
The new technique "allows us... to monitor in real time what is happening in the tumor in a way you never could be if you had to do a surgical procedure each time in order to get the samples as we do today."
In other words, doctors could know a lot sooner whether a therapy for cancer is succeeding or failing, and they could possibly tailor a patient's treatment accordingly.
The partnership brings together Veridex, the company which brought the earlier version of the test to the US market, together with ORD and clinical researchers to develop an improved version of the current technology.
"This collaboration is an opportunity to apply our past learning to the advancement of a platform that will ultimately benefit patients with cancer," said lead CTC chip researcher Mehmet Toner in a statement.
The US Food and Drug Administration approved the earlier generation technology for use in detecting cancer cells in the blood of patients with metastatic, or advanced stage, breast, prostate and colorectal cancer.
The planned "next-generation system" aims to be used by oncologists "as a diagnostic tool for personalizing patient care, as well as by researchers to accelerate and improve the process of drug discovery and development," said a statement by Veridex.
Dracopoli said it could be three to five years before FDA clinical trials produce results that show the technique works toward detecting and treating a broader range of cancers.
"A big part of the collaboration over the next few years will be testing the technology in prospectively defined clinical trials and confirming that this information actually helps guide therapies and improves patient outcomes," he said.
"We hope this will be a means of significantly improving the way that patients are treated, in the sense that we can get information about how a patient is responding to therapy in a way that we cannot right now."

Johnson & Johnson Teams With Mass General On Cancer Blood Test
Imagine doctors being able to find common cancers just by testing a little bit of blood. Sure would beat getting poked with a sharp needle, right?
Well today Johnson & Johnson and Massachusetts General Hospital announced a $30 million investment by the company in a partnership that aims to develop technology that could detect even a few cancers cells floating in a person's blood.
Mass General's Dr. Daniel Haber, one of the test's inventors, told the Associated Press, "This is like a liquid biopsy." The experimental test uses a plastic chip whose microscopic inner surfaces are covered in antibodies to grab cancer cells from the blood. Those cells can be analyzed in detail as well as counted.
Some early research has shown the approach has promise. It could, if all goes well, help doctors detect cancer and also to tailor treatment. But developing cool technology is one thing - making sure that it makes a difference in patient care is another.
The National Cancer Institute put together a lucid explanation of how the chips work, and also a cautionary note after a 2009 conference on the subject. Memorial Sloan Kettering Cancer Center's Dr. Howard Scher notes in the NCI piece that plucking the cancer cells from blood is just the start. Researchers have to show that the test results have prognostic value.
J&J's Veridex unit already sells a test called CellSearch to help guide treatment of metastatic forms of breast, prostate and colorectal cancer.
But the company discontinued a once highly touted genetic test to help surgeons figure out if breast cancer had spread to lymph nodes. The test, called GeneSearch, never caught on. It was expensive and gave quite a few false alarms. Surgeons weren't convinced it was so much better than what they had been doing.

Simple Blood Test to Detect Cancer? Not So Fast
Experts Question Whether Blood Test Could Personalize Cancer Treatment

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Researchers from Massachusetts General Hospital and health giant Johnson & Johnson are combining efforts to streamline a simple blood test that may be able to identify cancer cells in the blood stream of patients already diagnosed with a specific type of cancer.
But many experts question what place, if any, this test will have in the world of cancer prevention, early detection or even treatment.
The partnership is part of a nearly $30 million endeavor funded by Johnson & Johnson company Veridex and the advocacy group Stand Up to Cancer to develop and refine technology that will be able to accurately and quickly detect and analyze circulating tumor cells, the company said Monday.
Circulating tumor cells are a rare form of free-flowing cancer cells detached from the smallest of tumors and can be found at extremely low levels in the blood stream.
"For every one tumor cell in the blood there's over a billion normal blood cells in the circulation. So that's the big challenge for developing a test that can pull out one in a billion cells," said Dr. Daniel Haber, director of the cancer center at Massachusetts General Hospital in Boston.
CTC technology, approved by the Food and Drug Administration in 2004, is widely used in cancer centers to monitor a patient's response to treatment. But researchers now hope to expand its use to create a faster automated version that will analyze genetic components of a tumor and ultimately guide oncologists to personalize cancer treatments for patients.
"Harnessing the information contained in these cells in an in vitro clinical setting could enable tools to help select treatment and monitor how patients are responding," said Robert McCormack, head of technology innovation and strategy at Veridex.
Some cancer experts agreed the technology may be able to track some patients' cancer progression.
"It can help oncologists determine how well the drugs are working to kill cancer cells and it potentially could tell if the tumor returns at a later time," said Dr. Sarah Blair, associate professor of surgery in the division of surgical oncology at University of California San Diego.
However, previous research suggests that monitoring cells during treatment does not necessarily improve a patient's outcome. And many experts said not all indications of cancer cells in the body warrant treatment.
"Having the cells in the bloodstream does not necessarily mean that the cancer will spread and kill you," said Susan Love, president and medical director of the Dr. Susan Love Research Foundation, a breast cancer support and advocacy organization. "Just because you find them does not mean you know what to do with the information."
In some cases, our bodies may be able to fight off cancer cells without treatments such as surgery or chemotherapy, she said.
"We all have cancer cells in our body that are dormant," Love said. "We need to be careful not to over react to the presence of cancer cells when the treatment may actually be worse than the cure."
While in other cases, circulating tumor cells in the bloodstream that do signal cancer might mean the cancer may have already metastasized, she said.
Unlike other cancer screening tests that identify proteins released by cancer cells such as prostate-specific antigen for early prostate cancer detection, or rely on radiology studies such as mammography for early detection of breast cancer, CTC technology works when researchers look for actual tumor cells in the blood from a patient who is already diagnosed with a specific type of cancer.
According to Haber, for those already diagnosed with cancer, the test may be able to identify the cells' specific DNA, and doctors can subsequently tailor more effective treatments.
"Every patient has a different kind of cancer, every cancer has a different set of mutations and the better we get at treating cancer, the more we use specific drugs or smart drugs that are targeted against specific genetic abnormalities in the cancer," Haber said. "It's a way of understanding the cancer in real time and targeting therapy against the specific cancer at a particular moment in time."
And while researchers like Haber embarking on the collaboration hope the test will monitor cancer progression in cancer patients and ultimately personalize a cancer patient's treatment, many experts say it's still too early to tell.
"What we don't need are more tests that measure this or measure that," Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society wrote in his blog. "What we desperately need are tests that make a difference in the lives of our patients."
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