WEDNESDAY, July 2 (HealthDay News) -- A new technique for finding and analyzing stray cancer cells in the blood of lung cancer patients may make it possible for doctors to one day not only determine the genetic "signature" of particular tumors but to monitor changes in those cells and adjust treatments accordingly.

"I think this is key to personalized medicine," said Dr. Daniel Haber, senior author of a paper detailing the technology, to be published in the July 24 issue of the New England Journal of Medicine but released early online Wednesday. "As we get to targeted therapies in increasing numbers, and increasing understanding about the genetics that guide targeted therapies, we need a way to know what we're treating."

The "CTC chip" technology described in the new paper may also one day aid in the detection of cancers that are likely to spread. "This is an early warning sign we could use for earlier detection," said Haber, who is director of the Massachusetts General Hospital Cancer Center in Boston.

A previous study published in Nature used the CTC (Circulating Tumor Cells) chip technology to look at CTCs in lung, pancreatic, prostate, breast and colon cancers. The CTC chip successfully found such cells in 99 percent of the samples.

"We're very interested in the biology of these cells because no one has really been able to study metastasis [spread of cancer to other parts of the body] in action," Haber said. "These are the cells that cause metastases and the lethality of cancer. Now that we can identify and purify them in decent numbers, we can study and hopefully identify some of their vulnerabilities. It opens up a whole field of human metastasis and human therapies."

The CTC chip is a silicon chip about the size of a business card that has 80,000 "columns" coded with an antibody that acts like a "glue" to capture tumor cells "that have no business being in the blood," Haber explained.

Haber and his colleagues analyzed blood samples from 27 patients with non-small cell lung cancer, 23 who had EGFR gene mutations and four who did not. CTCs were identified in all samples and in genetic analyses from mutations 92 percent of the time.

Mutations in EGFR, a protein, can help predict whether these tumors will respond to a family of drugs called tyrosine kinase inhibitors.

"Even in the three to four months that we followed patients, the genetic make-up of the tumors changed. Resistant mutations appear and other mutations appear, obviously because we're doing things [with drug therapy] to the cancer," Haber said. "But the way we practice oncology we don't typically test for that. We do one biopsy which takes a tiny, tiny amount and assume that for the rest of the course, the tumor is the same."

"It's important to know in real time what you're treating," he continued. "We need to be able to follow the patient without needing to re-biopsy the tumor every time."

The technology is in its infancy, however. "This is still in a very, very early stage where it takes a long time to handle every sample, to flow the blood through the chip," Haber said. "This is a proof of principle that we can do this. We need a much more automated system for larger clinical trials."

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said that "you have to have some circulating cells to do this test, but it's very exciting because they're getting a genetic fingerprint of a tumor which will tell an oncologist what therapy the tumor might respond to or not respond to.

"It's expensive, but it may well be that if we can identify patients who can have a personalized regimen that works, we will be saving the cost of treating all those patients with regimens that don't work," he added.

Two other studies looking at lung cancer are published in the July issue of the Journal of Thoracic Oncology.

One, a review of existing studies, concluded that analyzing so-called volatile organic compounds in the breath of lung cancer patients may hold promise as a tool to detect cancer earlier. The technique deserves further attention, said researchers from the Cleveland Clinic.

For the second study, researchers at the University of Alabama at Birmingham found certain socioeconomic factors that may contribute to a higher death rate among blacks with non-small cell lung cancer. These included a higher smoking rate among blacks patients than white patients; a greater delay to the start of treatment among blacks; and less willingness to undergo chemotherapy among blacks than their white counterparts.

More information

Visit the U.S. National Cancer Institute for more on lung cancer.

MONDAY, June 30 (HealthDay News) -- A clinical trial will examine whether a new cancer treatment is as effective in humans as it's proven to be in mice, say researchers at Wake Forest University Baptist Medical Center in Winston-Salem, N.C.

The treatment involves transfusing white blood cells called granulocytes from healthy young donors -- whose immune systems produce cells with high levels of cancer-fighting activity -- into patients with advanced cancer.

A similar treatment using white blood cells from cancer-resistant mice cured 100 percent of lab mice with advanced cancer.

"In mice, we've been able to eradicate even highly aggressive forms of malignancy with extremely large tumors. Hopefully, we will see the same results in humans. Our laboratory studies indicate that this cancer-fighting ability is even stronger in healthy humans," lead researcher Zheng Cui, associate professor of pathology, said in a prepare statement.

The researchers will select 100 healthy donors, age 50 or younger, who have white blood cells with high cancer-killing activities. The recipients will included 22 patients with solid tumors that aren't responding to conventional therapy.

"If the study is effective, it would be another arrow in the quiver of treatments aimed at cancer," co-researcher Dr. Mark Willingham, a professor of pathology, said in a prepared statement. "It is based on 10 years of work since the cancer-resistant mouse was first discovered."

This phase II study is designed to determine whether cancer patients can tolerate a sufficient amount of transfused granulocytes for treatment. After three months, the patients will be evaluated to determine whether the treatment provided clear clinical benefits.

Details of the study were presented June 28 at the Understanding Aging conference in Los Angeles. If this trial proves successful, the researchers will then look at whether this treatment is best suited for treating certain types of cancer.

More information

For more on cancer treatments, visit the National Cancer Institute.

THURSDAY, June 26 (HealthDay News) -- Researchers have devised a new breast-imaging technology that appears to be as accurate as MRI scans but several times cheaper.

The technique, called molecular breast imaging (MBI), is still in the early stages of development, the scientists added.

"We envision MBI being useful for women who are not served well by mammography, those who have mammographically dense breast tissue, and those at increased risk for breast cancer," said study author Carrie Beth Hruska, a research fellow at the Mayo Clinic in Rochester, Minn. "We have been working on the technology for the last six years. However, there are a lot of technical challenges that have had to be overcome, so it's still in the very early stages for use in patients."

In fact, MBI is currently only used in the context of research studies.

Hruska was to present her findings Thursday at the Department of Defense "Era of Hope" Breast Cancer Meeting, in Baltimore.

Mammography is still the standard and most reliable screening test for breast cancer, and is likely to remain so for some time. But, mammography may be less effective in women who are at high risk for the disease or who have dense breasts (the two groups tend to overlap).

Last year, the American Cancer Society issued recommendations that women at high risk for breast cancer (such as those with the BRCA1 or BRCA2 gene mutation or a strong family history of the disease) have annual MRIs in addition to mammography.

MRIs have "high sensitivity," meaning they pick up a lot of unusual spots in the breast, but those spots aren't always malignant. And MRI screening is costly.

"MRI is very expensive, highly sensitive and not specific, so there are a number of false-positives," explained Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La.

Hruska said, "The jury is still out as to whether to recommend MRIs for women with dense breasts."

MBI is based on an intravenous injection of a radio "tracer" that circulates throughout the body and is preferentially taken up by cells that are more active than normal, such as cancer cells.

"We can then see this tracer with a special gamma camera we call the MBI system," Hruska explained. "This camera basically detects the gamma rays that are emitted from the tracer and, if there is more tracer, that's where the cancer is located." MBI is not affected by breast density and costs four-to-six times less than an MRI exam in both breasts, Hruska added.

In 48 patients suspected of having breast cancer who had undergone both MBI and breast MRI within a 30-day period, both MBI and MRI picked up disease in 47 of the 48 patients. In the final patient, two cancers went undetected by MBI but were picked up by MRI.

In all, 54 cancers in 32 patients were diagnosed. MRI picked up 53 cancers in 31 patients (a sensitivity of 98 percent) while MBI found 51 cancers in 30 patients (a sensitivity of 94 percent). One cancer was not diagnosed by MRI, MBI, mammography or ultrasound.

"It's a very interesting abstract and presentation," Brooks said. "It was a small number of patients, but it definitely bears looking at. This would be an interesting adjunct and maybe something worth looking into in the future with larger numbers of patients."

A second study, this one presented at the annual meeting of the Society of Nuclear Medicine in New Orleans recently, found that a custom-built scanner combining both positron emission tomography (PET) and computed tomography (CT) technologies might enhance current breast-imaging abilities. The technology may one day help with more personalized treatment options and could help determine if therapies with certain drugs are actually working in specific patients, said the authors, from the University of California-Davis in Sacramento.

More information

Visit the American Cancer Society for more on early detection of breast cancer.

MONDAY, June 23 (HealthDay News) -- Low socioeconomic status increases a cancer patient's risk of dying, say U.S. researchers who analyzed data on almost 14,000 breast, prostate and colorectal patients in seven states.

The study found that cancer patients with low socioeconomic status had more advanced cancers at time of diagnosis, received less aggressive treatment, and had a higher risk of dying within five years of diagnosis.

For example:

• Poorer women were less likely to receive radiation treatment after a lumpectomy or to receive anti-estrogen therapy when diagnosed with an estrogen receptor-positive (ER+) tumor.
• Prostate cancer patients who lived in less affluent areas were less likely to have a prostatectomy or receive radiation treatment than men who lived in areas of high socioeconomic status.
• Colorectal cancer patients of low socioeconomic status were less likely to receive chemotherapy.

While blacks and Hispanic patients were more likely than whites to live in poorer areas, but the link between increased risk of cancer death and low socioeconomic status applied to all racial and ethnic groups.

However, this was not true for patients 65 and older, perhaps because they have more universal access to cancer screening and treatment via Medicare, regardless of socioeconomic status, the researchers said.

"These findings support the need to focus on socioeconomic status as an important underlying factor in cancer disparities by race and ethnicity," wrote Dr. Tim Byers, of the University of Colorado Denver, and colleagues.

"We need better information on how access to health care contributes to differences in cancer outcomes by socioeconomic status in order to address the root causes of racial and ethnic cancer disparities in the United States," they added.

The study is published in the Aug. 1 issue of the journal Cancer.

Another study in the same issue found that initiatives designed to increase awareness and use of breast cancer screening may improve breast cancer survival rates for black American women, who have a higher risk of death from the disease than white women.

Researchers in Atlanta looked at the impact on black women of a program that included public education about the importance of mammography screening, breast self-exams, and seeing a trained health care provider. The program also included breast cancer survivors who supported newly-diagnosed breast cancer patients by encouraging them to follow-up with recommended medical care and helping them access financial, transportation and support services.

Between 2001 and 2004, the program conducted 1,148 community interventions for more than 10,000 participants. During that time, a total of 487 women were diagnosed and treated for breast cancer (89 percent black, 5 percent white, 2 percent Hispanic, and 4 percent other race/ethnicity) at the AVON Comprehensive Breast Center at the Georgia Cancer Center for Excellence at Grady Memorial Hospital in Atlanta.

Over the study period, the proportion of Stage 0 (early) non-invasive breast cancers increased from 12.4 percent to 25.8 percent, and the proportion of Stage IV (late) invasive breast cancers decreased from 16.8 percent to 9.4 percent.

More information

The U.S. Centers for Disease Control and Prevention has more about eliminating disparities in cancer screening and management.