Who doesn’t want cancer testing results at less cost, with greater speed and accuracy? Interdisciplinary innovators like Cancer Center at Illinois (CCIL) Program Leader Brian Cunningham are among the pioneers of the emerging field of point-of-care (POC) diagnostic technology aiming to make this dream a reality.
To present the case for the transformative shift in oncology underway thanks to POC molecular diagnostic technology, Cunningham initiated a multi-institutional, interdisciplinary collaboration. The team published a critical review paper arguing POC technology stands to dramatically change the future of cancer detection, therapy selection, therapy effectiveness monitoring, and personalized medicine.
For the paper, Cunningham organized clinical and engineering collaborators from the CCIL, University of Illinois Chicago, Huntsman Cancer Institute, Mayo Clinic, and Stanford School of Medicine. The team’s critical review paper is published in the Royal Society of Chemistry’s Lab on a Chip journal, and the issue’s cover photo features liquid biopsy POC technology developed in Cunningham’s lab that can produce oral cancer results in less than 15 minutes.
Leveraging case studies and clinical scenarios for oral squamous cell carcinoma, hepatocellular carcinoma, prostate cancer, and non-small cell lung cancer, the team explains both the challenges and opportunities of POC diagnostic technology. Challenges include funding and regulatory approval, sample collection methodology variations, and technology manufacturing and commercialization. But these challenges are part and parcel of any technology revolution.
Cunningham suggests this paradigm shift in the field of molecular diagnostics holds echoes of the transition from film to digital photography. In the era of film photography, the reader may recall, a photographer would have to ship off film to a central processing facility at higher cost and with long wait times. But with the advent of digital photography, a photographer can now view her captures rapidly and at less cost and often with much greater clarity. Similarly, the dependency upon centralized laboratory testing is a major obstacle in cancer detection, therapy, and treatment monitoring.
The Lab on a Chip journal featured point-of-care diagnostic technology developed in Cancer Center at Illinois researcher Brian Cunningham’s lab.
“Today, many molecular diagnostic tests still rely on centralized labs and delayed turnaround times, whereas the vision outlined in this work is a future where clinically actionable molecular info can be obtained much closer to the POC, enabling faster treatment and management decisions,” said Seemesh Bhaskar, first author of the team’s paper.
Cunningham’s lab is contributing to this POC revolution in numerous ways, including:
- Inventing, developing, and applying new biosensing platform technologies that have the capability for “digital precision” detection and counting of individual molecules and viruses.
- Inventing novel biochemistry methods that work with the biosensing technologies to make diagnostic test workflows that are simple and fast.
- Collaborating closely with clinicians who have specific but broadly important use cases for us to demonstrate in fields like cancer therapy selection, maternal health, nutrition, and veterinary diagnostics.
“The burden of cancer urges us to develop swift, precise, and accessible diagnostic responses that can overcome the limitations of diagnostic tests performed in centralized laboratory settings,” said Cunningham. “Point-of-care molecular diagnostics are emerging as transformative tools that enable decentralized testing across hospitals, outpatient clinics, oncology practices, and dental practices, thereby accelerating clinical decision-making to improve patient outcomes.”
Point-of-care cancer diagnostics holds promise for patients facing a variety of obstacles. Consider patients who experience considerable anxiety while waiting for test results to arrive, or patients who fail to make follow-up appointments for sample collection. Consider the barriers for people living in rural areas. Consider the lack of adequate health insurance or a fear of a cancer diagnosis that may lead many patients to avoid taking extra steps for diagnostic tests.
“Overall, there are many societal, personal, and financial barriers that lead to healthcare disparities,” reported Cunningham. “These issues could be partially addressed through the availability of low cost, rapid, noninvasive, and actionable molecular diagnostic tests that can be performed and interpreted during a visit to a physician’s office.”
By analyzing the global funding landscape, intellectual property demands, and regulatory frameworks that influence the transition of emerging technologies from academic research to commercial markets, in addition to the clinical and research lab case studies, Cunningham’s review not only summarizes the current state of the field but also provides a roadmap for translating POC cancer diagnostics into routine clinical practice. Such a review highlights the critical role of the basic science research and innovation emerging from the unique, interdisciplinary, cancer-engineering driven ecoystem at the Cancer Center at Illinois.
“POC molecular diagnostics for cancer is not a big part of healthcare yet,” concluded Cunningham. “The point of our paper is that there are big clinical needs and important scenarios where physicians want POC technology for specific purposes, and that there is technology developing that can address and remedy those needs.”
Cunningham (right) and postdoctoral researcher Seemesh Bhaskar analyze results from a laboratory experiment. Photo by Wang-Chien Chen.
Editor’s notes:
The research team acknowledges the following funding sources. Seemesh Bhaskar acknowledges funding from the Carl R. Woese Institute for Genomic Biology (IGB). Ugur Aygun acknowledges funding from the European Union’s Horizon Europe research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 101066038. Fatma Uysal Ciloglu is supported by the Scientific and Technological Research Council of Türkiye during her post-doctoral research.
Brian Cunningham is the Intel Alumni Endowed Chair in the Department of Electrical and Computer Engineering, a Program Leader at the Cancer Center at Illinois, an affiliate of the Department of Chemistry, the Department of Bioengineering, and the Holonyak Micro and Nanotechnology Laboratory, and a Working Group Leader for the CCIL and IGB’s collaboration at the Center for Genomic Diagnostics.
He can be reached at bcunning@illinois.edu.
The article “Point of care molecular cancer diagnostics” was published in the Royal Society of Chemistry’s Lab on a Chip journal and is available here.
DOI: doi.org/10.1039/d5lc01014d
This story was written by Jonathan King, CCIL Communications Coordinator.