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Drink helps track brain cancer

A chemical drunk by patients before surgery can make brain cancer easier to diagnose and monitor, a study shows

A chemical drunk by patients before surgery can make brain cancer easier to diagnose and monitor, a study shows

Picture shows a surgeon operating on a patient. A chemical that assists brain cancer surgery by making tumour cells fluorescent could also help to safely diagnose the disease and monitor its response to treatment, a study suggests.
Picture: Alamy

A chemical that assists brain cancer surgery by making tumour cells fluorescent could also help to safely diagnose the disease and monitor its response to treatment, a study suggests.

Brain cancer can be difficult to diagnose and monitor after treatment as tissue biopsies and radiation can injure the brain.

Researchers from Massachusetts General Hospital in the US looked at developing a less invasive alternative using a substance called 5-aminolevulinic acid (5-ALA), which patients drink before surgery.

All cells release particles called extracellular vesicles

Tumour cells in the brain take in ALA-5 while normal brain cells do not. Because all cells release particles called extracellular vesicles (EVs), investigators looked at whether EVs in the blood of patients with brain cancer might turn fluorescent pink when they drink 5-ALA, just as their brain tumours do.

The scientists showed that, in the presence of 5-ALA, brain cancer cells become fluorescent and secrete fluorescent EVs. When ALA-5 was given to mice with and without brain cancer, fluorescent EVs were present only in the circulating blood of those with brain cancer.

Researchers collected blood samples from patients before and after they drank 5-ALA before surgery. Patients with fluorescent tumours had a significantly higher number of fluorescent EVs in their blood, and the number of fluorescent EVs was related to the size of a patient’s tumour.

The authors said their findings offer ‘a novel liquid biopsy platform for confirming and monitoring tumour status.’

Reference

Jones P, Yekula A, Lansbury E et al (2019) Characterization of plasma-derived protoporphyrin-IX-positive extracellular vesicles following 5-ALA use in patients with malignant glioma EBioMedicine. doi: 10.1016/j.ebiom.2019.09.025

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