Pinned between the stomach and spine, the pancreas supervises both digestion and blood sugar in the body.\u00a0It’s\u00a0also the site of an aggressive cancer called pancreatic ductal adenocarcinoma, or PDAC.\u00a0<\/p>\n
PDAC is the most common type of pancreatic cancer, the\u00a0third-leading cause\u00a0of cancer\u00a0deaths in the U.S.\u00a0It’s\u00a0difficult to detect and recurs about 70% of the time\u00a0after treatment. Only\u00a013%\u00a0of those diagnosed survive more than\u00a0five\u00a0years.\u00a0<\/p>\n
A team of surgeons, anesthesiologists and engineers at the University of Illinois Chicago is studying how lidocaine, a\u00a0common\u00a0local anesthetic, affects pancreatic cancer cells released into the bloodstream during surgery.\u00a0Their\u00a0latest advancement\u00a0evaluates a method for capturing these rogue cells and is published in the journal Lab on a Chip.<\/p>\n
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I really expect that the results of this study may help our patients. The notion that lidocaine, which has been used to relieve pain for more than 65 years, may\u00a0mitigate\u00a0metastasis<\/a> and favorably affect patient outcomes is highly innovative.”\u00a0<\/p>\n
\n <\/p>\nDr.\u00a0Gina Votta-Velis, UIC professor of anesthesiology in the College of Medicine and lead investigator<\/p>\n
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In 2018, Votta-Velis received a grant from the\u00a0American Society of Regional Anesthesia and Pain Medicine\u00a0for this project. Circulating tumor cells are cancerous cells that break away from the tumor – often during tumor-removal surgery – and escape into the bloodstream. Patients with more aggressive\u00a0circulating\u00a0tumor\u00a0cells\u00a0in their blood have poorer prognoses and higher recurrence rates.\u00a0<\/p>\n
Votta-Velis said patients must recover from surgery before starting chemotherapy. In that\u00a0window of time,\u00a0circulating tumor\u00a0cells, or CTCs,\u00a0can travel throughout the body\u00a0and spawn new tumors.\u00a0But preliminary in-vitro studies have shown that lidocaine may hamper cells from bursting back out of the bloodstream,\u00a0instead\u00a0trapping them to be naturally cleaned out by our immune systems.<\/p>\n
“CTCs are the seeds of metastasis,” she said. “If we can detect them and decrease their aggressiveness with lidocaine infusion, we may\u00a0lower the risk of\u00a0the metastatic process.”\u00a0<\/p>\n
Because\u00a0circulating tumor cells are rare, isolating them could mean pulling 30\u00a0to\u00a040 cells out of the billions in\u00a0our bloodstream –\u00a0just like\u00a0pulling a needle from a haystack.\u00a0That’s\u00a0why Votta-Velis teamed up with fellow University of Illinois Cancer Center affiliate\u00a0Ian Papautsky,\u00a0the\u00a0UIC Richard and Loan Hill Professor of Biomedical Engineering in the College of Engineering. He specializes in microfluidics: how\u00a0small amounts\u00a0of fluids, like blood, flow through minute channels.\u00a0<\/p>\n
His contribution to the project is a small microfluidic device, fabricated from glass and plastic, measuring just a couple of inches\u00a0long\u00a0and\u00a0containing\u00a0channels just wider than a strand of hair. The device isolates cancer cells from a patient’s blood sample based on their size – a process referred to as a liquid biopsy<\/a>.\u00a0<\/p>\n
“CTCs are typically larger than white blood cells, which are larger than red blood cells. Cancer cells also tend to be softer and more moldable,”\u00a0Papautsky\u00a0said. “When we put the blood into this device, we can filter out the CTCs without modifying or damaging the cells.”\u00a0<\/p>\n
In 2019,\u00a0Papautsky’s\u00a0team\u00a0demonstrated\u00a0that this method picks out cancer cells with\u00a093% accuracy. This time, the researchers compared\u00a0Papautsky’s\u00a0method to a commercially available\u00a0tool called\u00a0EasySep,\u00a0which pulls cells apart magnetically.\u00a0Papautsky\u00a0said magnetic separation can be harsh\u00a0and\u00a0sometimes\u00a0destroy\u00a0the cells\u00a0it’s\u00a0attempting\u00a0to catch.\u00a0<\/p>\n
The researchers tested both systems –\u00a0EasySep\u00a0and their original method – with blood samples from pancreatic cancer patients<\/a>. They found that\u00a0Papautsky’s\u00a0method recovered eight times as many cancer cells and processed blood samples faster, in as little as 20 minutes.\u00a0<\/p>\n
“The\u00a0method’s\u00a0success is so important for asymptomatic cancers like pancreatic cancer, where a blood draw may be the only way to diagnose early,”\u00a0Papautsky\u00a0said.\u00a0<\/p>\n
Dr. Pier Giulianotti, a co-investigator and the\u00a0division\u00a0chief of\u00a0general,\u00a0minimally\u00a0invasive\u00a0and robotic\u00a0surgery\u00a0in\u00a0the College of Medicine, said this discovery opens the door to the next generation of personalized medical treatment.\u00a0<\/p>\n
“Science is based on little steps,” said Giulianotti, who is a world-renowned expert in the surgical treatment of hepatobiliary pancreatic cancer\u00a0malignancies. “And this is\u00a0a very good\u00a0step. Most malignant cancers in humans spread through the bloodstream. Understanding how cancer cells are released into the bloodstream and being able to control this process is\u00a0very, very important.”\u00a0<\/p>\n
Additional UIC researchers include Celine\u00a0Macaraniag, Ifra Khan, Alexandra\u00a0Barabanova, Valentina\u00a0Valle\u00a0and Alain\u00a0Borgeat. Jian Zhou of\u00a0Rush University Medical Center\u00a0is a\u00a0coauthor.<\/p>\n
Source:<\/p>\n
University of Illinois Chicago<\/a><\/p>\n
Journal reference:<\/p>\n