Cancer is one of the leading causes of morbidity and mortality worldwide. Approximately 35 million people are affected by this disease, there were 8.8 million cancer related deaths in 2015. According to the WHO, the incidence of cancer is predicted to rise about 70% over the next two decades.
Solutions for more effective cancer management will find great acceptance. Cancer monitoring plays a crucial role in effective cancer management. Regularly monitoring how well a cancer treatment is working overtime is the key to make early decisions on continuing the therapy, modifying protocols or seeking alternative therapies.
However, regular cancer monitoring is highly challenging because the current image-based tests (e.g. computed tomography, magnetic resonance imaging) for monitoring tumor status are highly costly (€2,000-€5,000) and require specialized and expensive equipment, typically available only at the biggest hospitals.
Life Length owns specific technologies for the evaluation of telomere biology: Telomere Analysis Technology® (TAT®) and Q-TRAP (Quantitative Telomere Repeat Amplification Protocol). While TAT® measures cellular telomere length (and associated variables, as the percentage of critically short telomeres), Q-TRAP allows accurate measurement of telomerase activity. ONCOCHECK is focused on the application of these technologies in cancer research. The great advantage of these technologies over competing blood tests on cancer tumor markers is that these technologies could monitor the vast majority of cancer types, offering a universal solution for cancer monitoring.
THE ROLE OF TELOMERES IN CANCER CELLS´BIOLOGICAL MACHINERY
The discovery of telomeres and telomerase was awarded with the Nobel Prize in 2009 and subsequently there has been a significant increase in healthcare community’s interest in incorporating and exploiting telomere measurement as a diagnostic tool in cancer and other age-related diseases. Telomeres are regions of repetitive sequences of nucleotides that protect the ends of chromosomes, stopping them from deterioration or from fusion with neighboring chromosomes. As part of cells’ natural aging processes, every time cells replicate, the telomeres become a little shorter. When telomeres are critically short, the cell stops dividing, enters into senescence and eventually dies.
However, compared to normal cells, cancer cells have different biological machinery. As a cell begins to become cancerous, it divides more often and its telomeres are shortened at a higher rate. If these cancerous cells followed the same biological mechanism than normal cells, they would become senescent and eventually die. Nevertheless, cancerous cells escape senescence/death and conversely, they become immortal with the ability to replicate indefinitely, even with shortened telomeres, resulting in uncontrolled tumor growth. To achieve this, the majority of tumor cells activate telomerase, an enzyme capable of elongating and repairing telomeres.
THE ADVANTAGES OF TELOMERE LENGHTH DETERMINATION IN CANCER MONITORING
The majority of cancer cell types present a shared characteristic which is the ability to preserve and propagate with critical short telomeres. Consequently, as a tumor swells and cancer advances, the number of short telomeres grows (the faster it increases the more aggressive the cancer is), whereas if tumor development is halted/reverted and cancer weakens, the percentage of short telomeres may become stable or slowed down. Hence, a constant measuring of the percentage of short telomeres can provide inestimable knowledge on the way the patients are being cured by the prescribed anti-cancer treatment (cancer tracking).
Moreover, determining the rate at which the percentage of short telomeres increases (attrition rate) it might be possible to determine cancer’s aggressiveness (prognosis). Most importantly, what makes telomere length determination of huge interest from a clinical perspective is that telomere length can be measured in peripheral blood, even for those patients affected by solid tumors.
Additionally, telomerase activity is also an important parameter to measure, as telomerase appears to be over activated in 85% of cancers. Measuring telomerase activity in blood samples could be correlated not only with tumor activity, but also with the response that the immune system is performing against the tumor.
The great majority of cancer markers validated so far and used in the clinic are specific to one type of cancer/tumor (e.g. some of the most commons are prostate-specific antigen in prostate cancer, carcinoembryonic antigen in colorectal cancer), while most of cancers cannot be managed by this approach due to the lack of validated tumor markers. This explains the huge interest in exploiting the potential of telomere measurements in cancer management over other tumor markers.