U of A hails 'FISH and chip' cancer test
Invention reduces wait from days to hours
EDMONTON - The University of Alberta has created a miniature lab-on-a-chip that will allow doctors to quickly figure out which chemotherapy will work best for a cancer patient, tailor treatments to them and monitor for relapses.
The hand-held glass chip, created by the U of A team, can perform an important diagnostic test known as FISH on a handheld device.
FISH (fluorescent in situ hybridization) allows oncologists to see abnormalities in cancerous bone marrow, blood or tumours.
The test currently can take days, but the lab on a chip reduces the wait to less than 24 hours, at a fraction of the cost.
"I feel this could be the most important thing that any of us may ever do," said Linda Pilarski, a cancer researcher leading the chip project with Chris Backhouse, an electrical engineering professor. "I'm really excited about it because I've always wanted my work to reach patients."
FISH involves inserting a substance similar to a dye into cancer cells. The dye sticks to certain chromosomes and becomes visible under fluorescent light.
Using the chip, a small, $1,000 machine and a biopsy or blood sample, doctors can see which chromosomes are missing, broken or abnormal and then choose a chemotherapy program or bone-marrow transplant proven to target that form of cancer.
The new test "will have great impact, and quite quickly, on the diagnosis of patients with a broad spectrum of diseases," said Dr. Roderick McInnes, scientific director of the Canadian Institutes of Health Research Institute of Genetics.
"Their FISH and chip technology should allow rapid and inexpensive diagnosis of important genetic changes that can underlie cancer and many developmental and neurological disorders."
Pilarski said the test "heralds the coming of personalized medicine" in which patients get what they need and the health-care system avoids costly trial-and-error attempts to find a treatment that works.
"Physicians urgently need this kind of information to make their treatment decisions," she said.
"The chromosomal analysis is so critical for cancer care because it tells doctors what patient outcome might be, how long they may survive, how bad their disease is likely to be and -- more importantly, perhaps -- it tells them what kinds of therapies the disease will respond to."
The technology will also help doctors catch relapses and tackle the cancer before it gets out of control.
Most patients currently can't get such fine-tuned care. A test to detect chromosomal mutations in certain cancer cells -- such as blood, breast, prostate or colorectal cancers -- can cost about $1,000 and requires a $1-million machine.
As a result, treatments for some cancer patients may not be effective and may cause adverse side-effects.
With their lab-on-a-chip, the tests are cheap -- one slide can hold 10 cell samples instead of one and be studied for $100 -- meaning patients can be monitored over time to detect aggressive new forms of the disease.
Willie Gruber, 48, said the test is crucial to put cancer patients at ease. He was diagnosed with multiple myeloma, a blood cancer, in January 2002 and was told he had four years to live.
But because doctors at the Cross Cancer Institute were researching his type of cancer, he received the expensive, $1,000 chromosome test. He then had to wait three gruelling weeks for the results.
"It's extremely stressful to worry about your future and not know what to expect," said Gruber, noting that doctors debated whether he needed aggressive chemotherapy or a less intense form. "Cancer that's treated earlier gets faster results."
In the end, the test showed his disease wasn't the most virulent form of multiple myeloma, but one that would respond to a bone-marrow transplant.
"It was a great relief," said Gruber, who is now cancer-free.
The lab-on-a-chip technology is so small and so cheap, Pilarski imagines a future where it's used in all medical clinics and hospitals.
"It's a lab anywhere," she said. "This is particularly important for northern or rural patients who can be tested in locations near home instead having to have a sick person make a difficult trip to a hospital in a city or a distant location."
Pilarski said it will likely be five more years before the test becomes widely available. A patent is already pending and the U of A is looking for investors.
The U of A research is being published this month in the journal IET Nanobiotechnology and will be presented at the 11th International Myeloma Workshop, a medical conference to be held in Greece from June 25 to 30.
jsinnema@thejournal.canwest.com
© The Edmonton Journal 2007
