Ajay Goel Lab Research Highlights
Biomarkers for Diagnosis, Prognosis, Treatment Response and Monitoring
Using a multiplicity of molecular approaches, City of Hope researchers have identified a diverse range of novel colorectal cancer biomarkers, including DNA, mRNA, microRNA and DNA methylation-based biomarkers. The potential clinical applications of these biomarkers are broad, and include diagnosis, prognosis, treatment prediction and monitoring of colorectal and other GI cancers, as well as patient stratification for clinical trials. Notably, most of these biomarkers have been validated using clinical samples from large patient cohorts and have been described in highly regarded peer-reviewed journals. These biomarkers offer three benefits that are key to clinical and commercial success:
- Multiple applications – novel, proprietary biomarkers for diagnosis, prognosis and monitoring of colorectal and other GI cancers
- Stand-alone or multiplexed – the biomarkers can potentially be used in stand-alone assays, or as part of multiplexed assays to achieve greater sensitivity and specificity
- Integration – the biomarkers are compatible with standard molecular platforms and workflows
Potential Clinical Applications That Can Be Addressed Using the Biomarkers Include:
- Cancer screening
- Differential diagnosis between colorectal cancer with metastasis and without metastasis
- Diagnosis of other GI cancers (esophageal, gastric, pancreatic, hepatic, etc.)
- Planning of cancer treatment
- Evaluation of cancer prognosis
- Monitoring of patients during and after treatment
- Surveillance in high-risk patients (e.g., hereditary predisposition)
- Cancer research, including clinical development
- Development of blood-based assays
New biomarkers for routine blood-based testing of colorectal cancer
Effective treatment of colorectal cancer is dependent on detection of the cancer at an early stage of progression. The growing use of colonoscopy over the last 45 years has aided in reducing the mortality associated with colorectal cancer, thanks to early detection. Nonetheless, public acceptance of colonoscopy is low, with fewer than 50% of individuals 50 years or older receiving colonoscopies. While blood-based tests such as the fecal occult blood test (fobt) and the fecal immunochemical test (fit) exist, their poor accuracy has limited their clinical utility. In recent years, there have been significant efforts to develop blood-based tests with improved sensitivity and specificity.
Recently, the Department of Molecular Diagnostics and Experimental Therapeutics has discovered and validated novel serum biomarkers, which show great promise as a blood-based test for the early detection, prognosis and treatment monitoring of colorectal cancer and other GI cancers. Importantly, these biomarkers, either alone or in concert with other biomarkers, can form the basis of a blood-based diagnostic test that is accurate, relatively non-invasive and sufficiently inexpensive to be useful for routine clinical testing, including screening and longitudinal monitoring.