Nahed wanted the test to gather as much information from the blood as possible to make it even more clinically valuable. To help improve the test, Stott, a mechanical engineer by training, expanded the test to detect not only CTCs but also exosomes. Every cell in the body, including tumor cells, releases tiny packets of cellular material, presumably as some form of cell-to-cell communication. These packets contain proteins, DNA and other identifying information. Also, since their membranes are formed from a pinched off portion of the membrane of the cell that produced them, they can be picked out of the blood stream using the same external markers.
Exosomes are a promising target for Nahed’s and Stott’s microfluidic device because they are tiny and may be more likely than tumor cells to flow across the blood-brain-barrier and into the blood stream. “The big thing we’re trying to do with our technology is improve the cancer signal overall,” says Stott.
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They aim to use their test to monitor glioblastoma patients during treatment. At the time of diagnosis, an MRI clearly shows the glioblastoma. But after it has been removed surgically, the image becomes less definitive. The effects of treatment can cause the image to falsely suggest that the tumor has returned. To answer this definitively, Nahed may need to perform a surgical biopsy. “If patients can avoid a second operation and instead use blood to detect the things we need to detect, this will have all been worth it,” says Nahed.
Nahed and Stott have begun enrolling patients to detect CTCs and exosomes using their blood test for glioblastoma. Patients who are being evaluated and treated for a brain tumor at Mass General can enroll in their research study and have their blood tested using the microfluidic device. They have been enrolling glioblastoma patients before surgery and intend to follow them as they progress through their care.
They are also extending this study, with the support of a private donor, to begin testing children with gliomas. “We’re over the moon because these patients have such small tumors that we can’t get biopsies,” says Stott. “We’re really excited to be doing something new for these children who are in desperate need for new diagnostic and treatment options.”
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