Scripps researchers develop alternative for some biopsies

The Scripps Research Institute has invented a way to spot and analyze cells that break away from solid tumors, possibly giving doctors a faster and better way to treat a variety of cancers.

The experimental blood test could supplement and, in some cases, replace, surgical biopsies, which can be costly, painful and difficult to conduct, says Peter Kuhn, the Scripps Research investigator who developed the test with pathologists and oncologists from across the country.

The test involves taking a blood sample from a cancer patient and adding a chemical that illuminates circulating tumor cells, or CTCs, the cells that break off from tumors that cause such diseases as cancer of the breast, prostate, pancreas, ovaries and lungs. The CTCs also can spread to distant sites in the body, causing metastatic cancer.

“We have a brand-new way of doing a biopsy. Instead of sticking a needle in your chest wall, we can see disease-derived cells in the blood,” said Kuhn, co-founder of Epic Science Inc., a new La Jolla company that’s working to refine the high-definition test, known as HD-CTC. The test, now in observational clinical studies as a research technology, will require FDA approval before it can be on the market.

Pathologists and oncologists already have a test, called CellSearch, that’s used to look for CTCs. But Kuhn says physicians need a test that is far more sensitive, and thus more useful for a wide array of cancer patients. The alternative, a surgical biopsy, can collapse a person’s lung, and there is concern that cancerous cells can be spread in the body when the needle is being removed.

The new HD-CTC tests addresses part of that problem by taking 40,000 images of the cells in each blood sample. It identifies and labels abnormal cells, and offers up a small number of photos for review by pathologists and oncologists.

“The types of biopsy that could potentially be replaced are ones that would occur further down the line as the disease evolves,” said Kelly Bethel, a Scripps Health diagnostic pathologist who contributed to the HD-CTC research.

“We’re trying to tailor your therapy. We’re trying to see if you have new mutations that have arisen in your cancer that has made it more resistant to the chemotherapy we’re trying to give. We can then see which other therapy might be better suited.”

“This is not going to cure cancer. But it is going to help us understand the evolution of disease. You can use the test right after someone has gone through treatment to see if they still have disease in their body, and whether there are circulating cells that put you at risk for metastasis.”


