"The Early Cancer Detection Problem: Challenges and Opportunities"
Gabe Kwong, Ph.D.
Wallace H. Coulter Department of Biomedical Engineering
The discovery of cancer at an early stage dramatically improves treatment outcomes, yet our current suite of blood-based diagnostics lack sensitivity and cannot reveal the presence of small, nascent tumors. The challenges are multifaceted and fundamental; recent mathematical studies showed that tumors may remain undetectable for an entire decade following tumorigenesis, reaching 1–2.5 centimeters in diameter. Here I will describe a new diagnostic framework based on the design and use of activity-based synthetic biomarkers for ultrasensitive and predictive monitoring of disease. Synthetic biomarkers target dysregulated protease activity to amplify detection signals into host urine, and have the capacity to discriminate tumors as small as a few millimeters in diameter—a threshold sensitivity that is otherwise challenging for medical imaging and blood biomarkers to achieve. Moreover, the number of clinical applications that are addressable with synthetic biomarkers is dramatically expanded by leveraging chemical encoding strategies. These include predicting disease progression and regression, monitoring patient response to drugs, and low-cost diagnostics for use in resource-limited environments. In the future, we envision synthetic biomarkers will significantly improve clinical decision making, accelerate clinical trials, and lower healthcare costs.