Point-Of-Care Paper-Based Test Could Diagnose Cancer at Bedside

When cancer metastasizes from its primary location, such as the lungs or breast, to the brain or spine, there are established treatment methods available. However, when these metastases reach the cerebrospinal fluid (CSF), resulting in a condition known as leptomeningeal disease (LMD), the median survival rate drops to approximately four months with treatment. If left untreated, median survival is only a matter of weeks. Alongside its low survivability, LMD is also challenging to detect promptly using current testing methods. Presently, it can take several weeks for doctors to confirm whether the cancer has spread to the CSF, followed by additional weeks to ascertain if a treatment has been effective. Given the urgency for patients facing one of cancer's most severe complications, researchers are now striving to develop a new test that can identify the spread of cancer to the central nervous system on the same day as the patient’s visit.

A two-year study being conducted by researchers at UCLA Health (Los Angeles, CA, USA) aims to create a new test that would facilitate same-day detection of LMD and allow doctors to monitor the effectiveness of treatments like chemotherapy in real-time. The research team is working on a diagnostic kit that combines sample processing with a specialized paper-assay test, akin to those utilized in at-home COVID and pregnancy tests. Their objective is to enable doctors to draw CSF from the patient and, after processing, apply it to the paper test at the care site. Ideally, the test would not only confirm the presence of cancer cells in the CSF that same day but also provide doctors with a measure of the concentration of those cancer cells.

Image: The rapid paper-based test could detect cancer cells in cerebrospinal fluid at the point-of-care (Photo courtesy of 123RF)

Current testing methods require that CSF be sent to a lab for processing, which can take one to two weeks for results. Moreover, the initial test typically has a detection rate of only 50%, necessitating additional tests to improve accuracy. Another limitation of these tests is their inability to accurately measure disease burden, which restricts their usefulness in evaluating treatment efficacy. The new test would enable real-time monitoring of circulating tumor cells, allowing doctors to quickly assess whether the treatment is effective. This would enable physicians to continue or adjust the treatment plan based on changes in cancer cell concentration. Obtaining this information promptly is vital given the poor survival rates associated with LMD. Additionally, the test could reduce costs associated with testing for LMD since it is paper-based and does not require laboratory processing. The study, which involves developing two types of diagnostics and testing with purchased cancer cells as well as some patient samples, is currently underway, with initial results anticipated in 2026.

“If the technologies work with cancer cells, then we'll start testing with cerebrospinal fluid samples from patients,” said Dr. Won Kim, Neurosurgical Director of the Brain Metastasis Program and co-investigator of the study. “If we're able to validate this in our human patients for the initial testing phase, we would like to move towards a multicenter clinical trial."