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New NCI grant will support Jefferson trial to study test to diagnose colorectal cancer spread

system is flawed because most pathologists examine only a thin slice of lymph node tissue, Dr. Waldman says, potentially missing a cancer. In addition, such a test lacks sensitivity, relying on a pathologist's eye to see colon cancer cells in a field of cells on a slide.

"There's clearly a problem with that system because about 20 percent of patients thought to have disease confined to the bowel show up with recurrent disease and ultimately die of the returning disease," he says. "There's thought to be micrometastases that have escaped histopathological detection."

Dr. Waldman thinks there is a better way. He uses a two-pronged approach: a powerful amplification technique called RT-PCR analysis to magnify the presence of cancer cells compared to normal cells and couples it with GCC, which he hopes will be a very specific marker for cancer. "Then you can take a lymph node and use the amplification technique to amplify the signal for cancer," he explains.

GCC appears to be very specific to colon cancer cells outside the intestine, and is only expressed in metastatic colon cancer cells that have spread there. By combining the marker with the amplification technique, which can detect one cancer cell in 10 million cells, researchers may have a very specific and sensitive way to detect metastatic colon cancer cells in the lymph nodes of patients undergoing colorectal cancer staging, he says.

"We hope to use this new molecular technique to improve the accuracy of colorectal cancer staging so that more people can receive chemotherapy and can benefit from it," he says.

The trial, for which recruitment has already begun, is looking at approximately 2000 patients at five centers: Jefferson, Fox Chase Cancer Center in Philadelphia, the University of Florida in Gainesville, McGill University in Montreal and a community hospital, Conemaugh Memorial Medical Center in Johnstown, Pa.

The trial will examine RT-PCR-GCC analysis as a method to determine
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Contact: Steve Benowitz
steven.benowitz@mail.tju.edu
215-955-5291
Thomas Jefferson University
20-Jun-2002


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