Cancer screening with multicancer detection tests: A translational science review

Multicancer detection (MCD) tests use a single, easily obtainable biospecimen, such as blood, to screen for more than one cancer concurrently. MCD tests can potentially be used to improve early cancer detection, including cancers that currently lack effective screening methods. However, these tests have unknown and unquantified benefits and harms. MCD tests differ from conventional cancer screening tests in that the organ responsible for a positive test is unknown, and a broad diagnostic workup may be necessary to confirm the location and type of underlying cancer. Among two prospective studies involving greater than 16,000 individuals, MCD tests identified those who had some cancers without currently recommended screening tests, including pancreas, ovary, liver, uterus, small intestine, oropharyngeal, bone, thyroid, and hematologic malignancies, at early stages. Reported MCD test sensitivities range from 27% to 95% but differ by organ and are lower for early stage cancers, for which treatment toxicity would be lowest and the potential for cure might be highest. False reassurance from a negative MCD result may reduce screening adherence, risking a loss in proven public health benefits from standard-of-care screening. Prospective clinical trials are needed to address uncertainties about MCD accuracy to detect different cancers in asymptomatic individuals, whether these tests can detect cancer sufficiently early for effective treatment and mortality reduction, the degree to which these tests may contribute to cancer overdiagnosis and overtreatment, whether MCD tests work equally well across all populations, and the appropriate diagnostic evaluation and follow-up for patients with a positive test.

Abstract 5571: Technologies for molecular epidemiology in cancer

Future success in molecular epidemiology depends on how quickly epidemiology adopts, optimizes and validates emerging technologies for molecular-scale analysis. In order to advance molecular epidemiology in cancer, the National Cancer Institute (NCI) supports the development of novel, next-generation, and cutting-edge molecular and cellular analysis technologies. Here we present past and present technology development efforts and their impact on cancer epidemiology. Some of the technologies, whose early-stage development was supported by the NCI, such as resequencing arrays, gene expression assay system, technologies which enable next generation sequencing, RNA preservative, rolling circle amplification of DNA, digital PCR system, functionalization of quantum dots, chromatin immunoprecipitation with next gen Sequencing, and multidimensional protein identification technology are now mainstay in basic and clinical research laboratories for genomic, epigenomic, transcriptomic and proteomic analysis. Additionally, these technologies have significantly contributed in identifying molecular determinants of cancer, and in assessing risk, disease progression and prognosis in large scale cancer epidemiology. Current awards support developing technologies for single cell analysis which can capture heterogeneity, simultaneous detection of multiple oncogenes, sensitive sequencing of geneomic/somatic mutations, targeted sequencing, rare variant detection, sequencing of ultralow-frequency mutations, epigenetic changes, kinome, multiplexed detection of microRNA, proteins, cytokines and metabolites, circulating tumor cells, and highthroughput protein-DNA interactions assessment. In addition, several novel biospecimen collection, preservation and processing technologies are also being supported with the potential to define the future of molecular epidemiology. Collectively, these technology development efforts supported by NCI provide a tremendous opportunity for molecular epidemiologists wishing to study archived samples collected in large-scale epidemiology efforts, and optimize and validate them for new molecular analyses.

Citation Format: Rao L. Divi, Mukesh Verma, Anthony Dickherber. Technologies for molecular epidemiology in cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5571. doi:10.1158/1538-7445.AM2015-5571

NCI investment in nanotechnology: achievements and challenges for the future

Nanotechnology offers an exceptional and unique opportunity for developing a new generation of tools addressing persistent challenges to progress in cancer research and clinical care. The National Cancer Institute (NCI) recognizes this potential, which is why it invests roughly $150 M per year in nanobiotechnology training, research and development. By exploiting the various capacities of nanomaterials, the range of nanoscale vectors and probes potentially available suggests much is possible for precisely investigating, manipulating, and targeting the mechanisms of cancer across the full spectrum of research and clinical care. NCI has played a key role among federal R&D agencies in recognizing early the value of nanobiotechnology in medicine and committing to its development as well as providing training support for new investigators in the field. These investments have allowed many in the research community to pursue breakthrough capabilities that have already yielded broad benefits. Presented here is an overview of how NCI has made these investments with some consideration of how it will continue to work with this research community to pursue paradigm-changing innovations that offer relief from the burdens of cancer.

Abstract 3499: Funding innovative technologies for cancer research at the National Cancer Institute

In the fall of 2013, the National Cancer Institute re-launched the Innovative Molecular Analysis Technologies (IMAT) program, committing up to $10.5 million through unique funding mechanisms (3 year R21s and R33s) to better support investigators through both the early and advanced stages of technology development over traditional funding mechanisms for exploratory research. The IMAT program has supported the development of various analytical and sample processing platforms that have made substantial contributions across the cancer research continuum, and the process of winning an award remains highly competitive. A variety of IMAT-supported research projects will be highlighted to demonstrate the variety and high level of innovation evident in the IMAT portfolio of supported research. An emphasis will be placed on recently completed projects so that investigators interested in next generation tools may become aware of possible developments through NCI-funded projects for their research. In addition, trends from recently awarded projects will be described to provide insight for potential applicants on the nature of the program and the competition. Potential projects of interest and identified technology gaps will also be discussed. The IMAT program continues to represent a unique resource for highly innovative technology development.

Citation Format: Anthony Dickherber. Funding innovative technologies for cancer research at the National Cancer Institute. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3499. doi:10.1158/1538-7445.AM2014-3499

Abstract ED03-05: Innovative technology development to advance biospecimen science

In 1998, the National Cancer Institute (NCI) established the groundwork for a highly successful program focused on innovative technology development to overcome persistent barriers for cancer researchers and clinicians. Unlike other initiatives of the time, the Innovative Molecular Analysis Technologies (IMAT) Program solicited only the most cutting-edge ideas, thus restricting its application pool to those projects that had the potential to be truly transformative. By doing so, the program filled a void that no other program at the NCI or NIH filled at the time. In 2005, the IMAT program introduced an additional focus on supporting innovative technology development that uniquely advanced the field of biospecimen science. Technologies supported by this mechanism have seen a disproportionately high level of success. The IMAT program continues to represent a unique resource for highly innovative technology development, but runs alongside several active programs at the NCI for supporting cancer-relevant technologies.

The full reauthorization of the IMAT program in fall of 2011 by the NCI for 2012-2013 demonstrates a significant commitment, especially under ever tightening fiscal constraints, to supporting innovative technology development for cancer research and clinical care. The IMAT program utilizes unique funding mechanisms to better support investigators through both the early and advanced stages of technology development over traditional funding mechanisms for exploratory research. Moreover, receipt of an IMAT award offers membership to a truly unique community of investigators that meet annually to share progress and exchange ideas. A variety of IMAT-supported research projects will be highlighted to demonstrate the variety and level of innovation evident in the IMAT portfolio of supported research. Potential projects of interest and identified technology gaps specific to the field of biospecimen science and with relevance to cancer health disparities will also be discussed.

Currently available funding opportunity announcements are active with three receipt dates open through September, 2013. Enthusiasm from the NCI Board of Scientific Advisors and NCI leadership for the IMAT program indicates that these solicitations are likely to be active beyond these dates. Technology developers from all fields of research are encouraged to apply.

Citation Format: Anthony Dickherber. Innovative technology development to advance biospecimen science. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr ED03-05.

Abstract 5078: The NCI-NIST-FDA effort to develop fitness-for-purpose biospecimen assessment standards: Development of quality assessment metrics and standards for optimal biospecimen utilization

The US Congress, through recent health care reform legislation, has directed the National Institutes of Health (NIH) to formulate a more aggressive strategy by which to translate scientific discoveries directly into the development of novel therapeutic and diagnostic capabilities. The National Cancer Institute (NCI) seeks to facilitate these efforts by targeting specific bottlenecks caused by the lack of standardization, quality metrics, and comparative benchmarks for research and clinical biospecimens used throughout the relevant discovery and validation pipelines. Many of the bottlenecks that currently impede routes to more effective biomarker discovery as well as drug, biologic and device development are impeded by a current lack of standards surrounding the research biospecimens used to advance this type of research.

The National Institutes of Standards and Technology (NIST), the Food and Drug Administration (FDA) and the NCI have engaged in an interagency effort to develop fitness-for-purpose quality assessment tools and metrics for the research biospecimens used by the clinical research, diagnostics, and technology development communities. An interagency workshop was convened consisting of biomedical and biospecimen scientists, standards/metrology scientists, commercial assay developers, experimental design and research methods experts, statisticians, and regulatory scientists that are among the leaders in their field. Subsequent to that workshop, a number of specimen quality assessment metric development projects were initiated to target metrics and standards that would have a significant impact on the development pipelines for diagnostics and therapeutics development, including the incorporation of certain regulatory efficiencies that could potentially accelerate development.

The NCI would like to present these ongoing projects and share ideas for future biospecimen quality assessment standards development projects for the cancer research, diagnostics, and technology development communities. Progress in designing such projects and preliminary results from experiments discussed in the October workshop will thus be described.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5078. doi:10.1158/1538-7445.AM2011-5078

Before you analyze a human specimen, think quality, variability, and bias

Personalized medicine requires capabilities to detect and measure health-associated biomarkers with increasingly specific and sensitive methods, putting analytical chemists at the front lines of translational research. Analytical scientists must be upstream in the experimental design process because the analysis of a biospecimen (tissue, blood, etc.) presents technical and experimental design complexities. (To listen to a podcast about this feature, please go to the Analytical Chemistry multimedia page at pubs.acs.org/page/ancham/audio/index.html.).

Abstract 984: Planning for caHUB, NCI's cancer human biobank

Many high-profile NCI initiatives are significantly impacted by biospecimen availability and quality. One of the newly delineated developmental pathways for transforming scientific discoveries into new clinical modalities for oncology, defined by NCI's Translational Research Working Group, is entirely biospecimen-based and is similarly impacted. Both direct experience with these initiatives as well as broader input from the scientific community, including recent results from a market research survey, have indicated a striking unmet need for high-quality human biospecimens. In response to this need, the Office of Biorepositories and Biospecimen Research (OBBR) is planning for the implementation of the cancer Human Biobank (caHUB). No centralized resource of this type exists at this time. This initiative will take advantage of resources already developed by the NCI, including the OBBR Biospecimen Research Network (BRN) and the NCI Best Practices for Biospecimen Resources (http://biospecimens.cancer.gov/practices/).

The OBBR is engaging in a detailed process with a variety of planning groups, to address the requirements for implementation of caHUB. caHUB will acquire and make available to the research community biospecimens that have been collected according to the highest technical and ethical standards; provide biospecimen reference samples that serve as benchmarks for specimen integrity and molecular type; conduct research that supports evidence-based biospecimen best practices; and create opportunities for collaboration and information exchange across the research enterprise. caHUB will ensure the quality of its inventory by acquiring biospecimens that have been collected and processed according to evidence-based standard operating procedures, annotated with comprehensive clinical, molecular, and collection data, and procured from patients who received high-quality care. caHUB proposes to contract with military, community, and academic institutions to collect biospecimens and their associated data. Through a caBIG®-compliant public network, caHUB will make specimens and data available to a broad research community, including academia, government, private foundations, and biotechnology and pharmaceutical industries, and enable new collaborations among researchers in all areas of investigation, thereby accelerating the pace of discovery and innovation.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 984.

An investigation of antibody immobilization methods employing organosilanes on planar ZnO surfaces for biosensor applications

One critical aspect for the development of label-free immunosensors is the employment of highly uniform and repeatable antibody immobilization techniques. In this study, we investigated the use of two different silane molecules (3-glycidyloxypropyl)trimethoxysilane (GPS), and (3-mercaptopropyl)trimethoxysilane (MTS) for the immobilization of fluorescently labeled IgG antibodies on planar ZnO surfaces. The chemical modification of the surfaces was investigated using water contact angle measurements, AFM, and fluorescence microscopy. The results of the water contact angle measurements indicate increased surface hydrophobicity after treatment with GPS and MTS as compared to the control. Surface modification was further verified through AFM measurements which demonstrate an increased surface roughness and particle height after treatment with antibodies. The results of the fluorescence studies indicate that the immobilization protocol employing MTS produced 21% higher fluorescence on average with greater uniformity than the GPS-based protocol, which indicates a higher overall density in antibody coverage on the surface of the ZnO. Acoustic sensor tests were employed to confirm the functionality of sensors treated with the MTS protocol. The results indicate that the immobilization protocol imparts sensitivity and specificity to the ZnO-based devices.

Lateral field excitation (LFE) of thickness shear mode (TSM) acoustic waves in thin film bulk acoustic resonators (FBAR) as a potential biosensor

Lateral field excitation (LFE) of a thin film bulk acoustic resonator (FBAR) is an ideal platform for biomedical sensors. A thickness shear mode (TSM) acoustic wave in a piezoelectric thin film is desirable for probing liquid samples because of the poor coupling of shear waves into the liquid. The resonator becomes an effective sensor by coating the surface with a bio- or chemi-specific layer. Perturbations of the surface can be detected by monitoring the resonance condition. Furthermore, FBARs can be easily fabricated to operate at higher frequencies, yielding greater sensitivity. An array of sensors offers the possibility of redundancy, allowing for statistical decision making as well as immediate corroboration of results. Array structures also offer the possibility of signature detection, by monitoring multiple targets in a sample simultaneously. This technology has immediate application to cancer and infectious disease diagnostics and also could serve as a tool for general proteomic research.