FCF Funded Projects

Liquid Biopsy for Active Surveillance of Fibrolamellar Hepatocellular Carcinoma

Status: Completed

Timeframe: 2021 – 2023

Goal: Develop a blood-based screening method to detect relapse in FLC patients

Principal Investigator: Gary S. Stein, PhD

Study overview: This study is focused on developing a blood-based screening method to detect relapse in FLC patients that have been diagnosed and treated by surgery. This screening protocol is intended to be non-invasive, to overcome limitations of current imaging strategies, and to be accessible and affordable for patients and their families. Currently, treatment of patients with FLC is limited by the understanding of how this cancer responds to therapies. Cancer physicians currently have limited ability to test for, and monitor patients’ response to therapy, and to detect disease progression. It is therefore important to have effective monitoring strategies for physicians to determine if patients are successfully remaining in remission, or if they are progressing towards the earliest stages of relapse. Catching relapsed tumors early, prior to spreads throughout the body, is critically important to increase FLC patient survival.

The study is evaluating the use of DnaJ-PKAc transcripts in circulating nucleated cells as a proxy for detecting the presence of circulating tumor cells (CTCs). A major challenge to detecting and quantitating CTCs is their extremely low abundance – roughly 1 to >100 per 7.5 mL of whole blood, compared to the billions of other cells typically found in blood. The objective of this initiative is to test whether the DnaJ-PKAc transcript can be detected in blood samples and to establish the threshold of transcript detection. We will utilize an engineered model of FLC that possesses the DnaJ-PKAc fusion gene as a substitute for actual CTCs. These pseudo-CTCs will be spiked into blood samples from normal donors to simulate whole blood from a metastatic or progressive disease scenario.