This project seeks to develop and test a more convenient detection modality for
colorectal cancer and to test feasibility for breast cancer screening through a blood
based test for cancer detection. Because detection of cancer is a fundamental need to
facilitate treatment and decrease patient mortality, the ultimate objective of this
proposal is to test applicability and context for the blood test, especially for patients
that either are not eligible or do not want to participate in currently approved
screening protocols.
Colonoscopy and mammograms are gold standard cancer screening modalities that are
recommended for detection of early-staged tumors, but there are many reasons why patients
are noncompliant with participation in these screening modalities. Neither colorectal
cancer nor breast cancer detection have reliable blood based cancer tests.
Availability of blood based cancer tests could increase patient compliance, as well as
decrease the associated mortality in finding cancer at later stages. The Altomare
laboratory has identified that FGF19 demonstrates unique characteristics that make it an
attractive serum marker for this concept. This UCF research group has found that in
studies using mice injected with human colorectal cancer cells, that FGF19 is secreted
into blood by tumors. The findings support the concept that malignant FGF19 from certain
tumors such as colorectal cancer can be leveraged in a diagnostic context to improve
cancer detection and access to screening.
Both colorectal cancer and breast cancer patients are priority populations for the
Florida Cancer Grant Programs. Importantly, FGF19 has not been tested for threshold,
sensitive or specificity as a blood marker for colorectal cancer. Baseline FGF19 blood
marker levels corresponding to colorectal cancer testing will be compared with those of
another cancer type, breast cancer, where aberrant FGF19 levels have been implicated but
also not tested. The investigators therefore also will test the applicability of serum
FGF19 to detect breast cancer, which has dysregulation of FGF19 and its receptor in
certain subtypes of breast tumors.
Objectives:
The primary marker that the investigators will look for is FGF19, a factor of normally
restricted spatially to parts of the intestine and gall bladder, especially following a
meal. The investigators will test in cancer patients whether FGF19 (or other associated
markers) are higher in the blood of subset of cancer patients.
The investigators pose the question of whether FGF19 is actively secreted into blood by
human tumors. In further examine its use as a blood biomarker, the investigators will
address whether higher levels of FGF19 cutoffs can be detected in the blood of colorectal
cancer or breast cancer patients over that of control participants. Successful completion
of this goal will, for the first time, establish whether tumor production of FGF19 in
human colorectal or breast tumors contributes to elevated levels in either, all or a
subset of patients compared to blood levels in people without cancer.