Nerd Nite, Liquid Biopsies, and the Future of Cancer Diagnostics
Last week I had the privilege of being an invited speaker at Nerd Nite. From Wikipedia:
Nerd Nite is an event usually held at a bar or other public venue where 2-3 presenters share about a topic of personal interest or expertise in a fun-yet-intellectual format while the audience shares a drink. It was started in 2003 by then graduate student (now East Carolina University professor) Chris Balakrishan at the Midway Cafe in the Jamaica Plain neighborhood of Boston and spread to New York City in 2006, where Matt Wasowski was tasked with expanding Nerd Nite globally. Nerd Nite is held at more than 80 cities worldwide.
One of those cities is San Diego, where the venue started up a few months back, held just outside the Liberty Public Market, right next to Stone Brewery. The Wikipedia description is apt, as most of the audience has a beer in hand. While the outdoor venue and proximity to Lindberg Field lead to some noisy interruptions, it seems to be a custom to raise one's drink and take a swig when the speaker is momentarily drowned out by jet noise.
All in all, there were about 40 people present of diverse intellectual curiosities and backgrounds, and when mixed with beer, lead to some really fun public discussions about the intersection of science and science fiction.
I gave a talk titled "The Future of Cancer Diagnostics: The Liquid Biopsy" where I outlined three main areas of cancer diagnostics (see photo) that can be revolutionized by emerging rare blood analyte technologies, especially those that can detect and characterize circulating tumor cells. In particular, I discussed our recent work on CTC-based AR-V7 protein as an emerging treatment selection biomarker in advanced prostate cancer. The next step will be clinical studies to investigate the clinical utility of monitoring resistance (i.e. once a patient gets a drug, not just before a patient gets a drug) using the same or similar types of tests.
The key advantages of liquid biopsy are accessibility, repeatability, and fewer side effects; no one will get a collapsed lung from observing circulating lung tumor cells, and there is no drill required to see circulating tumor cells from a bone metastasis in prostate cancer. Blood draws also do not require trips to hospitals, and can be repeated with much, much higher frequency than tissue biopsies, enabling the potential for sequential monitoring of cancer, which is a disease that evolves over time in cancer patients.
The challenges facing the use of circulating tumor cells lie in the sensitivity of detection, for which I discussed emerging technologies in tandem with established literature suggesting that there is biological feasibility for early detection of cancer using CTCs, and that the main hurdles right now are organizational (i.e. funding and time) required to run the clinical studies and clinical trials to expand clinical utility into the "early detection" area of cancer diagnostics. While treatment selection and recurrence monitoring are very important unmet needs in oncology, and are in late phases of clinical development, it is the early detection of cancer that could extend patient lives by decades, not just years.
It's a tantalizing vision of the future of oncology, but it is important to underscore that oncology is not changed by technology alone, but by the application and testing (i.e. clinical trials) of technology: do the benefits outweigh the potential harms and costs? What patients benefit, and how much? Emerging technology and studies have clearly demonstrated that the scales can be tipped well into the patients' favor, at least in the treatment selection area of advanced prostate cancer. It's a great proof of concept, and this rigor of clinical studies will need to be applied to the recurrence monitoring and early detection areas of oncology diagnostics as well.
…and this is where I got of my soapbox and had a sip of my beer! I really enjoyed the vibe, and will be a regular at Nerd Nite, and it's so incredibly important to have these types of public discourses about science and technology. Already looking forward to next month!