In Brain News, little brainstrust, Research News

Imperial College London researchers have developed a blood test that could offer an alternative method for the diagnosis of high-grade brain cancer. The technique has the potential to improve survival time for patients with glial tumours, including the most common and aggressive type, glioblastoma (GBM), from invasive and highly-risky surgeries. This discovery is demonstration of progress and some hope for the brain cancer community. It offers a non-invasive and patient-friendly alternative for early detection.

Clinical Validation at the Brain Tumour Research Centre of Excellence

The success of this blood test has been demonstrated through a clinical validation study conducted at the Brain Tumour Research Centre of Excellence, a collaborative effort between Imperial College London and Imperial College Healthcare NHS Trust. Published recently in the International Journal of Cancer, the study focused on patients with brain cancer, marking a significant milestone in the quest for advanced diagnostic tools.

The TriNetra-Glio Blood Test: Named TriNetra-Glio, operates by isolating circulating tumour cells that have detached from the tumour and entered the bloodstream. The isolated cells are then stained for identification under a microscope, providing a diagnostic liquid biopsy. Unlike traditional tests, TriNetra-Glio offers a risk-free and non-invasive method for detecting intact circulating tumour cells with the same cellular detail as an actual tissue sample.

Landscape and Limitations

While this new method of diagnosis may first appear to be a breakthrough in care, we need to also consider the wider picture and temper our expectations as research only progresses as a whole.

The clear benefits of this work include prompt diagnosis which will allow patients and their families to see improved wait times for diagnosis, lifting the burden of expediency from the clinical teams and allowing for a greater focus on wellbeing and next steps. Additionally, the less invasive nature of this option when compared to surgical biopsy allows for a more comfortable and less anxiety-inducing process across the board for those diagnosed.

Some limitations are revealed when considering these tests in the context of the wider standard of care. We know that surgery (resection) is the most effective treatment we have right now, and so these blood test diagnoses can’t be considered a replacement or a completely superior next step in care. When considering alternative treatments, we also must consider how pivotal it is to have frozen tissue as a result of a biopsy in order to be eligible for treatments such as immunotherapy (like DCVax) or other forms of molecular testing.

Tissue samples secured through biopsy and resection also pave the way for wider research. Tissue is required by scientists who are seeking to understand brain tumours.

A final consideration is the human element of spotting symptoms in the first place. Both options are limited by our ability to understand how brain tumours first present in patients.

“This alternative form of diagnosis serves as a puzzle piece in the larger picture of cancer care, but we should be mindful that it must compliment surgery and resection is still our best available treatment in the current landscape.” – Adam Thomson, Patient Involvement Officer, brainstrust

Potential Impact on Brain Tumour Patients

The test holds the promise of more prompt diagnosis, enabling tailored treatments based on biopsy results, potentially increasing survival rates. Moreover, it has the potential to eliminate the need for sometimes risky surgical biopsies, which pose significant dangers, particularly for those with underlying health conditions.

Funded by Datar Cancer Genetics, this research has already captured the attention of the United States Food and Drug Administration (FDA). The hope is now for a larger-scale study in the UK, with potential implementation within the next two years for patients with suspected high-grade tumours. The potential impact on reducing delays in diagnosis and treatment is particularly crucial, given the aggressive nature of brain tumours.

Conclusions

Imperial College London’s findings in developing a blood test for brain cancer detection marks a significant leap forward in the quest for improved diagnostics and treatments. The potential to spare patients from risky surgeries and offer a non-invasive alternative is a promising development for the brain cancer community. As we await further studies and potential regulatory approvals, the hope is that this innovation will soon become an integral part of brain cancer diagnosis, offering timely interventions and improved outcomes for those facing this devastating disease.

To read the published paper, click here.

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If you or someone you love is living with a brain tumour and have any questions around this latest news, or want to access support, give us a call on 01983 292 405 or email hello@brainstrust.org.uk. You can also visit our little brainstrust website which features support for children affected by brain tumour.

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Introduction

The Brain Tumour Data Dashboard lets you explore up -to-date, population level data about the brain tumours diagnosed in England between 2013 and 2015. Using the drop down menus on the left you can select different groups of patients to view in the charts below. In these charts the number of patients for every 100 diagnoses is displayed as images of people. Patients have been grouped by date of diagnosis, type of tumour, age, gender, and region in England.

For each group of patients you can explore the different routes to diagnosis, the proportion of those who received chemotherapy or radiotherapy, as well as the survival of the patients within each group. For more information about what these metrics mean please see the glossary.

How to use

  1. Select the year of diagnosis using the drop down menu.
  2. Select your patient group of interest from the four drop down menus in the following order:
    1. Tumour group
    2. Age at diagnosis
    3. Region of England
    4. Gender of patient
  3. To view a second chart to compare different groups of patients, click the ‘compare’ button.The second chart will appear below the first chart.

*Note that the tool is best used on a laptop or tablet rather than a mobile phone*

Unavailable data

Some of the data in these charts is not available.There are two main reasons for this:

  1. How the data has been grouped

If you cannot select a patient group from the drop down menus, the data is unavailable because of how the data has been organised.

Public Health England has grouped the data like a branching tree. The bottom of the tree contains all the patients with brain tumours, and then each branch divides the data by a certain characteristics, like age, or location of tumour. But the data is divided in an order, starting with location of the tumour (endocrine or brain), then by age, region, and gender. Age is at the start because it makes a bigger difference to survival rates and treatment rates than gender or region. Sometimes, after the data has been split by type of tumour and age, there is not enough data to be split again. This is because to protect patient confidentiality groups cannot contain less than 100 patients. Because some groups cannot be split further, you cannot create ‘totals’ for everyone by region or gender. For example, you cannot see results for all ages by region, or all brain tumours by gender. If these totals were calculated and released, it might be possible to identify patients, which is why Public Health England cannot release this data.

  1. Statistical reasons and data availability

If you can select a patient group from the chart menus, but the chart does not display, the data is unavailable for one of several reasons:

  1. Data is not yet available for the selected year from Public Health England.
  2. Data is not available because the data quality is too poor to release this statistic.
  3. Data is not available as the statistic is not appropriate for this group.
  4. Data is not available because the standard error of the estimate was greater than 20% and so the estimate has been supressed.

Up to date brain tumour data

Brain tumour data may influence the decisions you make about your care. Data also helps you understand the bigger picture, or landscape, in which you find yourself.

Brain tumour data and statistics influence the focus, and work of organisations like brainstrust. The information helps us to understand the scale and impact of the problems we are setting out to solve.

This tool helps you understand the landscape in which you find yourself having been diagnosed with a brain tumour. This landscape can be particularly tricky to navigate as there are many different types of brain tumour, all of which have a different impact.

The information you see represents the most up-to-date, official, population level brain tumour data available for England. Over time we will be adding to the brain tumour data available and publishing reports, with recommendations, as a result of what we learn from this data.

The data behind this content has come from Public Health England’s National Cancer Registration and Analysis Service (NCRAS) and is a direct result of the ‘Get Data Out’ project.

This project provides anonymised population level brain tumour data for public use in the form of standard output tables, accessible here: http://cancerdata.nhs.uk/standardoutput

Incidence

The number or rate (per head of population) of new cases of a disease diagnosed in a given population during a specified time period (usually a calendar year). The crude rate is the total number of cases divided by the mid-year population, usually expressed per 100,000 population.

Malignant

Malignant tumours which grow by invasion into surrounding tissues and have the ability to metastasise to distant sites

Mortality

The number or rate (per head of population) of deaths in a given population during a specified time period (usually a calendar year). The crude rate is the total number of deaths divided by the mid-year population, usually expressed per 100,000 population.

Non-malignant

Not cancerous. Non-malignant tumours may grow larger but do not spread to other parts of the body.

Survival

The length of time from the date of diagnosis for a disease, such as cancer, that patients diagnosed with the disease are still alive. In a clinical trial, measuring the survival is one way to see how well a new treatment works. Also called ‘overall survival’ or ‘OS’.

Routes to Diagnosis

Under the ‘Routes to Diagnosis’ tab in the Brain Tumour Data Dashboard, you can explore the ways patients have been diagnosed with brain tumours. There are many ways, or routes, for cancers to be diagnosed in the NHS. A ‘route to diagnosis’ is the series of events between a patient and the healthcare system that leads to a diagnosis of cancer. The routes include:

  1. Two Week Wait

Patients are urgently referred by their GP for suspected cancer via the Two Week Wait system and are seen by a specialist within 2 weeks where they are diagnosed.

  1. GP referral

Diagnosis via a GP referral includes routine and urgent referrals where the patient was not referred under the Two Week Wait system.

  1. Emergency Presentation

Cancers can be diagnosed via emergency situations such as via A&E, emergency GP referral, emergency transfer or emergency admission.

  1. Outpatient

Outpatient cancer diagnoses include diagnoses via an elective route which started with an outpatient appointment that is either a self-referral or consultant to consultant referral. (It does not include those under the Two Week Wait referral system).

  1. Inpatient elective

Diagnosis via an inpatient elective route is where diagnosis occurs after the patient has been admitted into secondary care from a waiting list, or where the admission is booked or planned.

  1. Death Certificate Only

Diagnoses made by Death Certificate Only are made where there is no more information about the cancer diagnosis other than the cancer related death notifications. The date of diagnosis is the same as that of the date of death.

  1. Unknown

For some patients with a cancer diagnosis, there is no relevant data available to understand the route to diagnosis.

 

More information

If any of the statistical terms in this section of the brainstrust website are hard to understand, we recommend looking them up here:

Cancer Research UK’s Cancer Statistics Explained

http://www.cancerresearchuk.org/health-professional/cancer-statistics/cancer-stats-explained/statistics-terminology-explained#heading-Seven

If you are looking for help understanding terms relating specifically to brain tumours, and treatment, then the brainstrust glossary is available here:

https://www.brainstrust.org.uk/advice-glossary.php