Outsmarting pediatric cancer

UI doctors try out a groundbreaking “liquid biopsy” to predict where cancer will develop

Pediatric experts at University of Iowa Stead Family Children’s Hospital will be among the first in the nation to use a new blood test designed to detect cancer and, in some cases, even identify where tumors will form.

“Tumors are so smart that they send out a message, way in advance, of which organ they’re going to,” says Yatin Vyas, MD, UI director of the division of pediatric hematology/oncology. “Very recent evidence has shown that that message is circulating in the blood.”

That message hides in genetic material called circulating tumor DNA (ctDNA). Tumor cells release ctDNA into the bloodstream. The new test analyzes a patient’s ctDNA to reveal that message.

It’s one of the latest advances in genetic tumor profiling, a highly personalized way to create targeted cancer treatments on a patient-by-patient basis.

Vyas says UI Stead Family Children’s Hospital is one of a handful of facilities in the U.S. that test both the DNA and RNA of every child’s tumor twice — first to choose a treatment, and then again after treatment to see if it’s working.

“But even in this modern era, we make a diagnosis, give the therapy, and then wait for a month or two to see how our therapy did,” Vyas says. “We wait for a cure or a relapse.”

That’s because each genetic test requires a biopsy, an invasive procedure that can’t be repeated frequently. A ctDNA blood test — also known as a “liquid biopsy” — gives UI doctors a powerful new tool that can cut the wait time.

“This test is a way to peer in and see what is happening between treatment and relapse.”

The promising technique is in its infancy, Vyas says, so the test will be used on a clinical trial basis to make existing targeted therapies more accurate.

“Our kids will give blood samples at different time points,” Vyas says. “We will use it to predict a relapse and then provide treatment proactively, even before it becomes a big tumor.”

Results will also be collected into a body of research data that will help to push the new technique closer to widespread use.

Vyas has urged all members of the pediatric hematology/oncology team to develop the deepest possible expertise in their fields. This will allow UI Stead Family Children’s Hospital to keep pushing the boundaries of cancer research, technology, and care.

“We are building a world-class pediatric cancer program here at the University of Iowa,” he says. “We are on the absolute leading edge of the cutting edge right now.”