Metabolic fingerprinting of tumors useful in bowel cancer patients

It is possible to assess how advanced a bowel cancer is by analyzing its metabolic fingerprint, according to new research.
Bowel cancer is the third most common type of cancer worldwide and more than 1 million new cases are diagnosed each year. Pinpointing the exact stage a tumor has reached is critical in determining which treatments to offer.

When determining the metabolic fingerprint, a blood, urine or tissue sample is analyzed for the concentrations of many different metabolites, which are the products of chemical reactions in the body’s cells. This mixture of metabolites alters as cancer occurs and grows. The researchers who collaborated on the new study, from Imperial College London, point out that clinicians could use metabolic fingerprinting in conjunction with available imaging techniques to perform the most accurate analysis of a tumor possible. This research is published in the journal Annals of Surgery. Physicians currently use a combination of CT, MRI, and ultrasound to assess how advanced a tumor is, but because these tests rely on visual estimates of the size and location of a tumor, they are not always as sensitive or specific. Previous studies have shown that these techniques regularly indicate that a tumor is more advanced or less advanced than it actually is.

Dr. Reza Mirnezami, lead author of the study from the Department of Surgery and Cancer at Imperial College London, said, “Investigating the stage of a tumor is critical in planning a patient’s treatment. It is becoming increasingly common that before we carry out surgical resection of a tumor we give treatments to try to shrink its mass, but the kinds of treatments we offer depend on our assessment of how advanced the tumor is. The more precise we can be, the better the patient’s chances of survival.

“Our research indicates that using metabolic fingerprinting techniques in addition to assessment with imaging studies could give us the clearest possible picture of how the cancer is progressing.”

For the new study, the researchers analyzed the metabolic fingerprint of 44 intestinal tumor tissue samples, provided by patients seen at Imperial College Healthcare NHS Trust, using high-resolution magic angle spinning nuclear magnetic resonance spectroscopy (HR-MAS NMR). Their results for determining the stage the cancer had reached were as accurate as existing radiological methods.

Lord Ara Darzi, Paul Hamlyn Chair of Surgery at Imperial College London, and lead author of the study, said, “We know that even with the impressive scanning technology we have available so far, it is not always possible to correctly verify the local stage of a cancer. Our study seems to indicate that if used in conjunction with medical imaging, metabolic fingerprinting could allow us to obtain more accurate information. This could give us more certainty about the correct treatment to administer to patients, and spare some of them from invasive treatment when they do not need it.”

The research also indicates that tumors adopt unique metabolic properties as they progress further, opening up new avenues for treatment. The researchers hope that it will ultimately be possible to identify different metabolic targets when the cancer is at different stages, in order to render the tumor impossible or slow it down. Professor Jeremy Nicholson, Head of the Department of Surgery and Cancer at Imperial College London and corresponding author of the study, said, “This study represents one part of our program to develop advanced technology to improve patient tolerability in the surgical setting and shows the enormous potential of using metabolic models to stratify patients and optimize treatment.”

Source: Medical News Today