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| <h1 id="IntroFollowup">Introduction</h1> | | <h1 id="IntroFollowup">Introduction</h1> |
− | <p class="lead"><!--(more information in <a href="https://2018.igem.org/Team:EPFL/Human_Practices"><span style="color:blue">Integrated human practices</span></a>)-->As in our project we have focused on a new therapeutic opportunity (personalized neoantigen vaccine) we found out that there is an unmet medical need for having companion personalized diagnostics. It is, in addition, critical to detect relapse in early melanoma stages, as the survival rates for patients drop dramatically to 20% in stage IV compared to 99% survival rate in stage I and II (<a href="#Siegel2018"><span style="color:blue">Siegel<i>et al.</i>, 2018</span></a>). </p> | + | <p class="lead">Through our interviews with health specialists and oncology experts (more information in <a href="https://2018.igem.org/Team:EPFL/Human_Practices"><span style="color:blue">Integrated human practices</span></a>) we assessed the necessity to have a non-invasive treatment companion to determine our vaccine efficacy. Here, we want to provide a proof-of-concept that would allow us to monitor the patient’s response by using the same set of identified neoantigens used for our vaccine. |
− | <p class="lead">Thus, the aim of this part is to provide a proof-of-concept that would allow us to monitor the efficiency of our vaccine by using the same set of identified neoantigens.</p> | + | We also believe that it is important to be able to detect relapses in early melanoma stages, as the survival rates for patients dramatically drop to 20% in stage IV compared to 99% survival rate in stage I and II (<a href="#Siegel2018"><span style="color:blue">Siegel<i>et al.</i>, 2018</span></a>). </p> |
− | <p class="lead">Once our cancer treatment has proven effective and no biomarker corresponding to our targeted neoantigens can be detected through liquid biopsies there is still a need to be alert for cancer recurrence. </p>
| + | <p class="lead">To answer these needs, we envision a new generation of diagnostic tools by which a liquid peripheral blood draw could give an accurate prognosis regarding the elimination of the tumor cells and, by targeting specific biomarkers, be a good predictor of relapse. This requires a detection system that is both highly sensitive and specific since single base pair polymorphisms, barely detectable in the blood, can lead to tumorigenesis.</p> |
− | <p class="lead">We envision a new generation of diagnostic tools by which a simple sample from patient’s blood (liquid biopsy) could give us an accurate prognosis regarding the elimination of the tumor cells targeted by our vaccine. This requires a detection system that is both highly sensitive and specific since single base pair polymorphisms, barely detectable in the blood, can lead to tumorigenesis.</p>
| + | <p class="lead">Our idea is to develop a Cas12a detection system coupled to an amplification step. This detection system is rapid, sensitive and specific enough to reliably detect these biomarkers.</p> |
− | <p class="lead">Our idea is to address this problem by using a Cas12a detection system which is coupled to an amplification step. This could give us a detection system that is rapid, sensitive and specific enough to reliably detect these biomarkers.</p> | + | |
| </div> | | </div> |
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| <h1 id="Biomarkers">Biomarkers and Liquid Biopsies</h1> | | <h1 id="Biomarkers">Biomarkers and Liquid Biopsies</h1> |
| <p class="lead">Through our dialogue with many health specialists (more info in <a href="https://2018.igem.org/Team:EPFL/Human_Practices"><span style="color:blue">Integrated Human Practices</span></a>), we realized that there was an urgent need for practitioners to be able to evaluate the response to targeted treatments. Assuming, for example, that the treatment has no effect on a certain tumor population, this would be ruled out, saving expenses as well as unnecessary side effects to the patient. In addition, the tumor heterogeneity often generates cases of resistance to targeted therapy (<a href="#Calapre2017"><span style="color:blue">Calapre <i>et al.</i>, 2017</span></a>), via the selection pressure they generate. However, repeated tumor biopsies to study genomic changes are unthinkable in most cases, as these methods are often painful, risky and time-consuming.</p> | | <p class="lead">Through our dialogue with many health specialists (more info in <a href="https://2018.igem.org/Team:EPFL/Human_Practices"><span style="color:blue">Integrated Human Practices</span></a>), we realized that there was an urgent need for practitioners to be able to evaluate the response to targeted treatments. Assuming, for example, that the treatment has no effect on a certain tumor population, this would be ruled out, saving expenses as well as unnecessary side effects to the patient. In addition, the tumor heterogeneity often generates cases of resistance to targeted therapy (<a href="#Calapre2017"><span style="color:blue">Calapre <i>et al.</i>, 2017</span></a>), via the selection pressure they generate. However, repeated tumor biopsies to study genomic changes are unthinkable in most cases, as these methods are often painful, risky and time-consuming.</p> |
− | <p class="lead">Recently, several studies have shown that non-invasive <b>liquid biopsy</b> methods are a promising way to detect cancer relapse and monitor tumor burden in cancer (<a href="#Heitzer2017"><span style="color:blue">Heitzer <i>et al.</i>, 2017</span></a>), as these constitute a quick, reliable and easily obtained samples.</p> | + | <p class="lead">Recently, several studies have shown that non-invasive <b>liquid biopsy</b> methods are a promising way to detect cancer relapse and monitor tumor regression (<a href="#Heitzer2017"><span style="color:blue">Heitzer <i>et al.</i>, 2017</span></a>). Liquid biopsies represent a fast, reliable and easy way to obtain samples compared to the invasive nature of solid biopsies which are generally time-consuming, difficult to perform frequently and not without some risks to the patient.</p> |
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| <p class="lead"> | | <p class="lead"> |
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| <div class="tab-pane fade show active" id="ctDNA1" role="tabpanel" aria-labelledby="home-tab"> | | <div class="tab-pane fade show active" id="ctDNA1" role="tabpanel" aria-labelledby="home-tab"> |
| <br> | | <br> |
− | <p class="lead">Circulating free DNA (cfDNA) is thought to originate from a natural phenomenon during which apoptotic cells release some of their fragmented DNA into the bloodstream (<a href="#Harris2016"><span style="color:blue">Harris <i>et al.</i>, 2016</span></a>).</p> | + | <h3>ctDNA - A look at the tumor DNA</h3> |
− | <p class="lead">In cancer patients the proportion of cfDNAs from necrotic tumor cells - known as “<b>circulating tumour DNA</b>” (<b>ctDNA</b>) - represents a large part of the circulating DNA. | + | <p class="lead">Circulating free DNA (cfDNA) is thought to originate from a natural phenomenon during which apoptotic cells release some of their fragmented DNA into the bloodstream (<a href="#Harris2016"><span style="color:blue">Harris <i>et al.</i>, 2016</span></a>). |
| + | In cancer patients the proportion of cfDNAs from necrotic tumor cells - known as “<b>circulating tumour DNA</b>” (<b>ctDNA</b>) - represents a large part of the circulating DNA. |
| These short DNA fragments (~166 bp) contain virtually all the possible genetic defects that can be found in the original tumor cell population, including somatic point mutations and translocations (<a href="#Harris2016"><span style="color:blue">Harris <i>et al.</i>, 2016</span></a>). Moreover, literature has shown that levels of ctDNA in the blood are correlated with progression or remission of disease in several cancers, including melanoma (<a href="#Gray2015"><span style="color:blue">Gray <i>et al.</i>, 2015</span></a>; <a href="#Girotti2016"><span style="color:blue">Girotti <i>et al.</i>, 2016</span></a>; <a href="#Tsao2015"><span style="color:blue">Tsao <i>et al.</i>, 2015</span></a>; <a href="#Calapre2017"><span style="color:blue">Calapre <i>et al.</i>, 2017</span></a>).</p> | | These short DNA fragments (~166 bp) contain virtually all the possible genetic defects that can be found in the original tumor cell population, including somatic point mutations and translocations (<a href="#Harris2016"><span style="color:blue">Harris <i>et al.</i>, 2016</span></a>). Moreover, literature has shown that levels of ctDNA in the blood are correlated with progression or remission of disease in several cancers, including melanoma (<a href="#Gray2015"><span style="color:blue">Gray <i>et al.</i>, 2015</span></a>; <a href="#Girotti2016"><span style="color:blue">Girotti <i>et al.</i>, 2016</span></a>; <a href="#Tsao2015"><span style="color:blue">Tsao <i>et al.</i>, 2015</span></a>; <a href="#Calapre2017"><span style="color:blue">Calapre <i>et al.</i>, 2017</span></a>).</p> |
− | | + | <p class="lead"></p> |
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| <div id="ctDNABiom"> | | <div id="ctDNABiom"> |
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| <div id="SYBRParagraph" class="collapse" data-parent="#miRNADesignAmpl"> | | <div id="SYBRParagraph" class="collapse" data-parent="#miRNADesignAmpl"> |
| <div class="card-body"> | | <div class="card-body"> |
− | <p class="lead">Two main alternatives are suitable in order to test the efficacy of Rolling Circle Amplification (<a href="#Deng"><span style="color:blue">Deng <i>et al.</i>, 2014</span></a>; <a href="#Qiu"><span style="color:blue">Qiu <i>et al.</i>, 2018</span></a>). First of all, the amplicons can be tested by means of an agarose gel to verify the size; nonetheless, this method shows some limitations because of the large size of the amplicons. Indeed, as we also saw from our experiments (link to the <a href="https://2018.igem.org/Team:EPFL/Notebook-Detection"><span style="color:blue">Notebook</span></a>), the size of the amplicons after a 2 hour-RCA is so large that the band is extremely close to the well. </p> | + | <p class="lead">Two main alternatives are suitable in order to test the efficacy of Rolling Circle Amplification (<a href="#Deng"><span style="color:blue">Deng <i>et al.</i>, 2014</span></a>; <a href="#Qiu"><span style="color:blue">Qiu <i>et al.</i>, 2018</span></a>). First of all, the amplicons can be tested by means of an agarose gel to verify the size; nonetheless, this method shows some limitations because of the large size of the amplicons. <!--Indeed, as we also saw from our experiments (link to the <a href="https://2018.igem.org/Team:EPFL/Notebook-Detection"><span style="color:blue">Notebook</span></a>), the size of the amplicons after a 2 hour-RCA is so large that the band is extremely close to the well.--> </p> |
| <p class="lead">A more valid alternative is instead to perform a real-time fluorescence measurement by means of SYBR Green I.</p> | | <p class="lead">A more valid alternative is instead to perform a real-time fluorescence measurement by means of SYBR Green I.</p> |
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