A day in the life of clinical laboratory science

July 20, 2016
One nice thing about my job is that, as part of it, I have the opportunity—and professional obligation—to read news releases about advances in laboratory medicine or the science that underlies it, and to follow the continuous flow of important advancements. One day shortly before this August 2016 issue of MLO went to press, there was an especially impressive group of news releases that came across my desk. Lab Week is in April, but July 6 was a kind of unofficial lab day, I guess, because I had the pleasure of learning that day about all of the following:
  • New screening test using blood biomarkers may identify risk of colon cancer recurrence. Ludwig Institute for Cancer Research scientists, working in collaboration with colleagues in Australia and the United States, have shown that fragments of tumor DNA circulating in the blood can be used to gauge the risk of colorectal cancer recurrence and the efficacy of chemotherapy following surgery. The finding, published in Science Translational Medicine, is an important step toward the development of a noninvasive and more effective test for the detection, monitoring, and treatment of cancer.
  • “Omics” data improves breast cancer survival prediction. Precise predictions of whether a tumor is likely to spread would help clinicians and patients choose the best course of treatment. New research reveals that profiling primary tumor samples using genomic technologies can improve the accuracy of breast cancer survival predictions compared to clinical information alone. Although this method is not ready for use in the clinic, the proof-of-principle study, published in GENETICS, shows that survival predictions improve when they incorporate comprehensive data on which genes are active in tumor samples compared to noncancerous tissues from the same patient.
  • Blood test to detect DNA fragments shed from colon cancers predicts disease’s recurrence. Scientists at the Johns Hopkins Kimmel Cancer Center and University of Melbourne report they have used a genetic test that spots bits of cancer-related DNA circulating in the blood to accurately predict the likelihood of the disease’s return in some—but  not all—of a small group of patients with early-stage colon cancer. The DNA-based test, described in the July 6 issue of Science Translational Medicine, if confirmed by further research, could eventually help clinicians decide which patients need additional treatment at the time of their initial diagnosis of stage 2 cancer.
  • Inexpensive blood test can discriminate between bacterial, viral infections, study finds. Researchers at the Stanford University School of Medicine have made an important breakthrough in their ongoing efforts to develop a diagnostic test that can tell healthcare providers whether a patient has a bacterial infection and will benefit from antibiotics. The team used publicly available patient gene expression data to pinpoint just seven human genes whose activity changes during an infection; their pattern of activity can distinguish whether an infection is bacterial or viral.
  • Genetic testing can help deliver precision medicine to men with advanced prostate cancer. Genetic testing in men with advanced prostate cancer could pick up a significant proportion whose disease may be caused by inherited mutations in genes involved in repairing DNA damage, a major new study reveals. Testing prostate cancer patients for mutations in key DNA repair genes could identify those who may benefit from precision treatments that specifically target DNA repair weaknesses in cancer cells.

“Although this method is not ready for use in the clinic…” is the caveat that can be applied to all of these fascinating examples of the breakthroughs that molecular approaches may one day provide for clinical diagnostics—but that makes them no less exciting. I remember how the late Paul Harvey sometimes used to include medical research news in his daily radio commentaries, leading with “Today’s news of perhaps the most lasting significance is….” Who knows which of these items may prove to be the news of most lasting significance for July 6, 2016?