Lymphatic Metastasis

Singapore-headquartered Qritive has integrated its AI modules with US-based Corista's image management platform DP3. According to a press statement, the combined solution leverages AI to screen for both prostate and colon cancers, quantify IHC markers, and detect lymph node metastasis. It allows pathologists to prioritise and grade specific cases while improving the detection of hard-to-diagnose cancers. It also enables pre-reviewed AI analysis of digital pathology images utilising any whole slide image scanning device and LIS. Corista's DP3 is a DICOM-compliant pathology software that enables voice collaborations, remote case reviews, and global consults. It can integrate with either in-house or commercially available image analysis systems and features a proprietary LIS Connector. WHY IT MATTERS Pathology departments have been overwhelmed with huge demands for diagnostic screening which rose with a rapidly ageing population, a growing incidence of chronic diseases, and the emergence of various epidemics. Integrating AI into pathology workflow has the potential to raise pathologists' efficiency. It delivers high-quality diagnoses while helping free up pathologists' time to focus on more complex cases. "Our partnership with Qritive will advance the use of [AI] applications to support the growing demands on pathologists to keep up with the pace of their workloads and the challenges of cancer diagnosis," said Liz Wingard, CEO and co-founder of Corista. "Corista's image management system combined with the assistive power of Qritive's AI modules is the ideal workbench for pathologists to conduct diagnostics with ease, consistency, and precision," Qritive CEO and co-founder Aneesh Sathe claimed. THE LARGER TREND In the same week, Qritive also announced the launch of its latest AI module for prostate cancer diagnosis. Called QAi Prostrate, the software module analyses whole slide images of prostate core needle biopsies, identifies prostatic adenocarcinoma region, and segments and classifies them into benign and malignant areas. It also provides a detailed summary explaining the tumour size and percentage for each slide or region of interest. The module can be integrated with any standard digital pathology system, as well as with existing workflows using an open API interface through customisable middleware. At the start of the year, Qritive raised $7.5 million in a funding round, which was intended to support its global expansion, regulatory approval attempts, and development of more AI imaging analysis solutions.

Various approaches for treating lymph node metastasis exist. But now, a research team has combined two forms of therapy to create a superior treatment method than conventional chemotherapy. Lymph node (LN) metastasis is a sign that things are going from bad to worse in cancer patients, and prompt treatment is vital. A research team from Tohoku University's Graduate School of Biomedical Engineering has developed a lymphatic drug delivery system (LDDS), where anticancer drugs are injected directly into the metastatic LNs. When combined with total-body irradiation (TBI), the new LDDS has a superior antitumor effect than conventional chemotherapy on early stage LN metastasis. TBI provides a uniform dose of radiation to the entire body, penetrating areas in which traditional chemotherapy cannot reach. Recently, TBI has shown positive results in activating immune responses and altering the tumor microenvironment. Meanwhile, LDDS is mainly used for treating metastatic LNs locally. The research team hoped to widen LDDS's usage to prevent distant metastases -- where the cancer spreads from the primary tumor to a distant lymph node. "We knew a combination of treatment that enhances systemic tumor immune effects would be an important therapeutic strategy," said graduate student Shota Sora, who was part of the research team headed by Professor Tetsuya Kodama. Sora and his colleagues investigated the dual therapy of LDDS and TBI for LN and distant metastases on metastasis model mice. They used irradiation gamma rays (a onetime dose of 1.0 GY) and anticancer drug CDDP adjusted with a solvent to have an osmotic pressure of 1987 kPa and a viscosity of 11.3 mPas. An in vivo bioluminescence imaging system, a high frequency ultrasound system, and histology showed the new therapy was more effective than employing LDDS or TBI alone. After the therapy, the expression of immune-response related genes (CD4, CD8, and IL-12b) increased in the spleen, indicating an activated immune response. "With the results showing that both TBI and LDDS improve the efficacy of LB metastasis and distant metastases therapy, this novel approach is a promising way to treat cancer patients," added Sora.

April 21, 2021 14:00 UTC This new, blood-based test successfully identifies individuals with lymph node metastasis associated with high-risk T1 colorectal cancer and potentially could help people with non-high-risk early-stage colorectal cancer avoid unnecessary colon surgery. DUARTE, Calif.--(BUSINESS WIRE)-- Scientists at City of Hope, a world-renowned independent research and treatment center for cancer and diabetes, have developed a novel, noninvasive liquid biopsy test for detecting lymph node metastasis in individuals with high-risk T1 colorectal carcinoma. Research on the development of the blood test was reported in a new study published in Gastroenterology, a journal of the American Gastroenterological Association. This blood-based test is an example of the theranostic (a term that combines “therapeutic” and "diagnostic”) approach at City of Hope, whose goal is to help every patient receive personalized treatment appropriate for their specific disease. Development of blood-based biopsies to detect and monitor tumors is one of the leading-edge technologies under investigation to help patients with cancer. Most individuals suspected of having T1 colorectal cancer with lymph node metastasis undergo radical surgery to remove affected parts of the colon. Unfortunately, only 5-10% of these individuals actually had lymph node metastasis after final examination of the removed colon, indicating that surgery was not necessary for the majority of these people. “Since radical surgery dramatically reduces quality of life for patients, improving the success rate of identification of high-risk individuals with lymph node metastasis remains the challenge in T1 colorectal cancer diagnosis,” said Ajay Goel, Ph.D., M.S., chair of the Department of Molecular Diagnostics and Experimental Therapeutics at City of Hope, and the study’s senior author. “In the future, we hope to improve our confidence in identifying which individuals truly have lymph node metastasis via this novel biomarker-based liquid biopsy test for T1 colorectal cancer, in combination with clinical and pathological criteria.” The publication by Goel and colleagues focused on translating their previous findings of identifying lymph node metastasis with T1 colorectal cancer in a tissue-based assay into a blood-based assay. After refining and validating the panel of RNA biomarkers, the blood test was found to accurately identify lymph node metastasis with high sensitivity (83.3%; a higher value means fewer cases of disease are missed), and specificity (76.2%; a higher value means the test can accurately identify those without disease). “Obtaining results with more than 80% accuracy (sensitivity) in finding lymph node metastasis in the blood was a completely unexpected finding and is a complete game changer,” Goel said. City of Hope researchers are excited about the potential of this new liquid biopsy test to complement current risk assessment for lymph node metastasis for individuals with early stage T1 colorectal cancer. The technology is patent pending. Goel indicated that further work will be done to optimize the blood-based assay to improve sensitivity and continue to validate the assay in prospective clinical trials. “There are several steps between where we are now and where we want to go — detecting lymph node metastasis in colon cancer from a blood sample — but without doubt this is an encouraging first step.” Support for this study was provided by grants from the National Cancer Institute, and the National Institutes of Health (CA72851, CA181572, CA184792, CA202797 and CA187956). About City of Hope City of Hope is an independent biomedical research and treatment center for cancer, diabetes and other life-threatening diseases. Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope’s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies, and numerous breakthrough cancer drugs are based on technology developed at the institution. Translational Genomics Research Institute (TGen) became a part of City of Hope in 2016. AccessHope™, a wholly owned subsidiary, was launched in 2019, dedicated to serving employers and their health care partners by providing access to City of Hope’s exceptional cancer expertise. A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation’s “Best Hospitals” in cancer by U.S. News & World Report. Its main campus is located near Los Angeles, with additional locations throughout Southern California and in Arizona. For more information about City of Hope, follow us on Facebook, Twitter, YouTube or Instagram.