ROCHESTER, Minn. — Little is known about what causes ovarian cancer, and there is no way to detect it early yet. About 75% of the time when someone is diagnosed with ovarian cancer, it has already progressed to stage 3 or stage 4, which means it has spread to other parts of the body. Mayo Clinic physicians, researchers and patients had been working together to learn more about this devastating disease when a 22-year-old patient, who has two rare genetic conditions that dramatically elevate lifetime cancer risk, came to Mayo Clinic.

The patient carries a hereditary BRCA2 mutation, which is one of the genes that causes hereditary breast and ovarian cancer (HBOC) syndrome, and a hereditary TP53 mutation, which causes Li-Fraumeni syndrome.

At Mayo Clinic, she was diagnosed with breast cancer. Imaging also revealed she had an ovarian cyst. Although the cyst was benign, she chose to have a mastectomy and hysterectomy with removal of her ovaries and fallopian tubes, a procedure called a bilateral salpingo-oophorectomy, because of her elevated cancer risk. Upon further examination, her Mayo Clinic physician and research team detected early, hidden changes in the cells lining her fallopian tubes, revealing signals that may point to the first signs of ovarian cancer before symptoms or visible lesions appear.

"Our team glimpsed a rare and revealing phenomenon in epithelial biology, uncovered through the cells of a young patient living with profoundly high-risk genetic conditions. Using cutting-edge, single-cell technologies, we traced how her epithelial cells were developmentally altered in ways that signaled a high risk for lethal ovarian cancer. These insights could pave the way for future strategies to detect the disease in its earliest, precancerous stages when prevention is still possible," says Nagarajan Kannan, Ph.D., director of the Stem Cell and Cancer Biology Laboratory at Mayo Clinic and co-lead author of this study published in JCO Precision Oncology.

Jamie Bakkum-Gamez, M.D., the patient's gynecologic oncology surgeon at Mayo Clinic, says she is determined to find a way to detect ovarian cancer earlier to help save more patients' lives.

"We know that the most aggressive and common form of ovarian cancer often actually starts in the fallopian tube. However, why the fallopian tube and how it starts are not yet known. Knowing how ovarian cancer begins and forms could not only lead to the development of earlier screening tools, but also more personalized risk-reduction strategies and improved guidance around the timing of preventive surgeries and fertility planning," says Dr. Bakkum-Gamez, who is a co-lead author of this study.

Watch: Dr. Jamie Bakkum-Gamez on revealing hidden signs of ovarian cancer risk

Journalists: Broadcast-quality sound bites are available in the downloads. Please courtesy: "Mayo Clinic News Network." Name super/CG: Jamie Bakkum-Gamez, M.D./ Gynecologic Oncology/Mayo Clinic

Together, Dr. Kannan and Dr. Bakkum-Gamez have established a living fallopian tube biobank at Mayo Clinic. The cells and tissues donated by patients help scientists study how ovarian cancer begins — cell by cell — directly in human tissue. From the patient specimens, organoids, or small versions of the fallopian tubes, can be grown. The biobank includes organoids from patients with average-to-high ovarian cancer risk and specializes in inherited cancer mutations like the ones associated with HBOC syndrome and Li-Fraumeni syndrome.

"The precise cellular origin of ovarian cancer remains one of the greatest unanswered questions in cancer prevention — limiting our ability to intervene early and save lives. This work lays the foundation for a new era of early detection and precision prevention for ovarian cancer, especially for patients with inherited risk such as BRCA mutations."

Nagarajan Kannan, Ph.D.

Ovarian cancer precursor

A healthy fallopian tube consists of two main types of epithelial cells: multiciliated cells that have hundreds of cilia, or hairlike appendages, that help move the fertilized egg through the fallopian tube and secretory cells that secrete fluids to nourish and protect the developing embryo. But in the fallopian tube cells collected from the patient with HBOC syndrome and Li-Fraumeni syndrome, the scientists saw something they had never seen before. Instead of the two types of epithelial cells, the secretory cells vastly outnumbered the multiciliated cells across the fallopian tube. They also found that secretory cells were driving chronic inflammation — an established contributor to cancer development.

"Through single-cell RNA sequencing, we could see the disruptions in the development of cells lining the fallopian tube lumen — findings that could help reshape how we understand and ultimately prevent ovarian cancer," says Megan Ritting, co-lead author and Mayo Clinic Graduate School of Biomedical Sciences doctoral candidate. Ritting spearheaded the use of cutting-edge genomic technology in this study.

Furthermore, oral contraceptives containing progestins, or synthetic analogs of the hormone progesterone that is produced by the ovaries, can be used to reduce ovarian cancer risk by up to 50%. However, Ritting and the research team were surprised to see that this patient's fallopian tube cells did not have any progesterone receptor proteins, which suggests oral contraceptives may not have been effective in reducing the patient's risk for ovarian cancer.

"With the generous partnership of patients who allow their cells to be studied using advanced technologies, including organoid models, we are making critical progress in understanding how these cancers develop. This work represents an important step toward identifying opportunities to develop preventive strategies, treatments and approaches that could reduce the risk of fallopian tube and ovarian cancers," says Dr. Bakkum-Gamez.

In the next steps of this research, using the living fallopian tube biobank, the scientists are investigating how and where earliest origins of ovarian cancer take root.

Review the study for a complete list of authors, disclosures and funding. 

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Kelley Luckstein, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic researchers capture first signs of ovarian cancer risk appeared first on Mayo Clinic News Network.

Some of the most harmful genetic changes in cancer are also the hardest to see. These structural alterations, deep within a tumor's DNA, can fuel aggressive growth and evade standard testing, especially when tissue samples are small or degraded. 

To address this challenge, Mayo Clinic researchers have developed a new computational tool called BACDAC that shines a light on these elusive genomic patterns. The tool helps researchers identify signs of genomic instability using DNA sequencing that reads the entire genome, even in low-purity or low-coverage samples. 

The tool could help clinicians better predict how a tumor will behave and guide more personalized treatment choices. 

Detecting chromosome changes

At the core of BACDAC's approach is the concept of ploidy, which refers to the number of complete sets of chromosomes in a cell. While normal human cells have two sets (46 chromosomes total), cancer cells often show large-scale gains or losses, disrupting this balance and enabling unchecked growth. 

"This tool lets us see a layer of the genome that's been invisible until now. We've spent decades studying the biology of genomic instability. This is the first time we've been able to translate that knowledge into a tool that works at scale." 

George Vasmatzis, Ph.d.

In a study published in Genome Biology, the research team used BACDAC to analyze more than 650 tumors across 12 cancer types. The tool helped researchers detect signs of whole-genome doubling, where a tumor duplicates all of its DNA. This type of abnormal ploidy is often linked to aggressive behavior and treatment resistance. 

"This tool lets us see a layer of the genome that's been invisible until now," says George Vasmatzis, Ph.D., a lead author of the study and co-director of Mayo Clinic's Biomarker Discovery Program. "We've spent decades studying the biology of genomic instability. This is the first time we've been able to translate that knowledge into a tool that works at scale." 

BACDAC also provides a visual summary of a tumor's genomic landscape. A custom output called the Constellation Plot offers an intuitive view of whether the tumor's chromosomes are stable or disrupted. This may help researchers and pathologists interpret results more easily. 

Next, the Mayo Clinic team plans to further validate BACDAC and develop it into a clinically deployable diagnostic tool. It may help inform treatment decisions by providing a clearer view of a tumor’s structural changes. 

The study was supported in part by the Mayo Clinic Center for Individualized Medicine and the Mayo Clinic Center for Digital Health. For a complete list of authors, disclosures and funding, review the study. 

More recent research from Dr. Vasmatzis

Mayo Clinic researchers reveal personalized approach to brain cancer monitoring

Mayo Clinic researchers have developed a personalized blood test that detects tumor DNA to help track the progression of high-grade gliomas more quickly and less invasively. Read more.

The post New Mayo Clinic tool exposes hidden cancer DNA changes that may drive treatment resistance appeared first on Mayo Clinic News Network.

Late-breaking abstract featured at ASCO 2025

ROCHESTER, Minn. — Colon cancer is the third most prevalent form of cancer in the U.S., and while screening has helped detect and prevent colon cancer from spreading, major advancements in treating colon cancer have lagged.

Now, new research led by Mayo Clinic Comprehensive Cancer Center found that adding immunotherapy to chemotherapy after surgery for patients with stage 3 (node-positive) colon cancer — and with a specific genetic makeup called deficient DNA mismatch repair (dMMR) — was associated with a 50% reduction in cancer recurrence and death compared to chemotherapy alone. Approximately 15% of people diagnosed with colon cancer exhibit dMMR and, to date, these tumors appear less sensitive to chemotherapy. The results of the multi-center study were presented during a plenary session at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

"The findings from our study represent a major advance in the adjuvant treatment of dMMR stage 3 colon cancer and will now change the treatment for this type of cancer," says oncologist Frank Sinicrope, M.D., who led the study. "It's extremely rewarding to be able to offer our patients a new treatment regimen that can reduce the risk of recurrence and improve their chances of survival."

Until now, the standard treatment after surgery for any stage 3 colon cancer has been chemotherapy. However, the researchers note that approximately 30% of patients experience cancer recurrence despite this treatment. 

Watch: Dr. Frank Sinicrope discusses Mayo Clinic immunotherapy study

Journalists: Broadcast-quality sound bites with Dr. Frank Sinicrope are in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network."

The clinical trial enrolled 712 patients with dMMR stage 3 colon cancer that had been surgically removed and who had cancer cells in their lymph nodes. The immunotherapy given in this study was an immune checkpoint inhibitor, known as atezolizumab, which activates one's immune system to attack and kill cancer cells, which are responsible for cancer recurrence and spread. The patients — who lived in the U.S. and Germany — received chemotherapy for six months along with immunotherapy and then continued with immunotherapy alone for another six months.

Dr. Sinicrope and others previously studied patients with colon cancer whose cells are unable to repair errors during DNA replication that create a nucleotide mismatch, a condition called dMMR. They noted that these patients' tumors showed a striking increase in inflammatory cells within the tumor, including those that express the target of immune checkpoint inhibitors. This sparked the idea of using immune checkpoint inhibitors to make the immune cells more effective in attacking and killing the cancer cells.   

Based on the data from this study, Dr. Sinicrope recommends this combination of immunotherapy and chemotherapy treatment to be the new standard treatment for stage 3 deficient mismatch repair colon cancer. The research team plans to approach the National Comprehensive Cancer Network, a nonprofit organization consisting of 33 leading cancer centers, including Mayo Clinic, with this recommendation.  

The study included patients with Lynch syndrome, the most common form of hereditary colon cancer, as these patients can have tumors that show deficient mismatch repair (dMMR).

"We're changing the paradigm in colon cancer treatment. By using immunotherapy at earlier stages of disease, we are achieving meaningful benefits for our patients," says Dr. Sinicrope.

Review the abstract for a complete list of authors, disclosures and funding. 

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

About Mayo Clinic Comprehensive Cancer Center 
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

• Kelley Luckstein, Mayo Clinic Communications, newsbureau@mayo.edu

The post Immunotherapy boosts chemotherapy in combating stage 3 colon cancer appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Mayo Clinic Comprehensive Cancer Center researchers will present their latest oncology findings at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, scheduled to be held May 30–June 3 at the McCormick Place Convention Center in Chicago. The event, recognized as one of the largest gatherings in the field of cancer research, will feature 59 Mayo Clinic-authored abstracts highlighting advancements in cancer care.

Among the standout presentations are practice-changing studies focused on chemotherapy approaches, artificial intelligence (AI) applications in oncology, cancer care at home and new therapies for breast cancer and melanoma — all focused on improving treatment options for patients with cancer.

Highlights include:

Plenary Session: Randomized trial of standard chemotherapy alone or combined with atezolizumab as adjuvant therapy for patients with stage 3 deficient DNA mismatch repair (dMMR) colon cancer (Alliance A021502; ATOMIC)
Presentation time: Sunday, June 1, 1:05 to 1:17 p.m. CDT
Session title: Special Sessions
Presenter: Frank Sinicrope, M.D., medical oncologist and gastroenterologist

Clinical Science Symposium: Perception and concerns of the hematology and oncology (HemOnc) workforce about artificial intelligence (AI) in clinical practice (CliPr) and medical education (MedED)
Presentation time: Saturday, May 31, 2:03 to 2:15 p.m. CDT
Session title: The Future Is Now: Innovations in Medical Education
Presenter: Guilherme Sacchi de Camargo Correia, M.D., oncology fellow (senior author is Rami Manochakian, M.D., thoracic medical oncologist)

Oral Abstract Session: Tissue-free circulating tumor DNA assay and patient outcome in a phase 3 trial of FOLFOX-based adjuvant chemotherapy (Alliance N0147)
Presentation time: Friday, May 30, 3:57 to 4:09 p.m. CDT
Session title: Gastrointestinal Cancer — Colorectal and Anal
Presenter: Frank Sinicrope, M.D., medical oncologist and gastroenterologist

Oral Abstract Session: [212Pb]VMT-α-NET therapy in somatostatin receptor 2 (SSTR2) expressing neuroendocrine tumors (NETs): Dose-limiting toxicity (DLT) observation participants after one-year follow-up and preliminary report for expansion participants.
Presentation time: Friday, May 30, 4:09 to 4:21 p.m. CDT
Session title: Developmental Therapeutics — Molecularly Targeted Agents and Tumor Biology
Presenter: Thorvardur Halfdanarson, M.D., medical oncologist       

Oral Abstract Session: NeoACTIVATE arm C: Phase II trial of neoadjuvant atezolizumab and tiragolumab for high-risk operable stage 3 melanoma
Presentation time: Tuesday, June 3, 2025, 10:45 a.m. to 10:57 a.m. CDT
Session title: Melanoma/Skin Cancers
Presenter: Tina Hieken, M.D., breast and melanoma surgical oncologist

Poster Session: Cancer Care Beyond Walls (CCBW): A randomized pragmatic trial of home-based versus in-clinic cancer therapy administration
Session time: Sunday, June 1, 9 a.m. to noon CDT
Session title: Care Delivery and Quality Care
Presenter: Roxana Dronca, M.D., medical oncologist and the site deputy director of Mayo Clinic Comprehensive Cancer Center in Florida

Poster Session: A pilot single-arm, pragmatic trial in progress of in-home versus in-clinic subcutaneous nivolumab administration through Cancer Care Beyond Walls (CCBW) program (connected access and remote expertise)
Session time: Sunday, June 1, 9 a.m. to noon CDT
Session Title: Care Delivery/Models of Care
Presenter: Dina Elantably, M.B., B.CH., oncology fellow (senior author is Roxana Dronca, M.D., medical oncologist and the site deputy director of Mayo Clinic Comprehensive Cancer Center in Florida)

Poster Session: Initial results of MC200710 investigating therapeutic vaccine (PDS0101) alone or with pembrolizumab prior to surgery or radiation therapy for locally advanced HPV associated oropharyngeal carcinoma, a phase 2 window of opportunity trial
Session time: Monday, June 2, 9 a.m. to noon CDT
Session title: Head and Neck Cancer
Presenter: David Routman, M.D., radiation oncologist

Poster Session: ALISertib in combination with endocrine therapy in patients with hormone receptor-positive (HR+), HER2-negative (HER2–) recurrent or metastatic breast cancer: The phase 2 ALISCA-Breast1 study
Session time: Monday, June 2, 9 a.m. to noon CDT
Session title: Breast Cancer — Metastatic
Presenter: Tufia Haddad, M.D., medical oncologist

Poster Session: Estrogen receptor expression in residual breast cancer following neoadjuvant chemotherapy
Session time: Monday, June 2, 9 a.m. to noon CDT
Session title: Breast Cancer — Local/Regional/Adjuvant
Presenter: Sarah Premji, M.D., oncology fellow (senior author is Matthew Goetz, M.D., breast medical oncologist, and the Erivan K. Haub Family Professor of Cancer Research Honoring Richard F. Emslander, M.D.)

For more information about 2025 ASCO visit: https://www.asco.org/annual-meeting.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

About Mayo Clinic Comprehensive Cancer Center 
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact on-site at ASCO:

• Kelley Luckstein, Mayo Clinic Communications, 507-202-8655, luckstein.kelley@mayo.edu

The post Mayo Clinic experts present key cancer research findings at ASCO appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Millions of people are affected by chronic dry mouth, or xerostomia, an agonizing side effect of damaged salivary glands. While chemotherapy and radiation treatment for head and neck cancer are the most common causes of this, aging, certain medications and other factors, including diabetes, stroke, Alzheimer's disease and HIV/AIDS, can also cause chronic dry mouth. Currently, there is no cure for it.

Mayo Clinic researchers have established the world's first biobank of human salivary gland tissue-organoids that opens the door to research to find a cure.

"This unique biobank resource overcomes a major barrier we've faced in the field, namely: limited access to standardized salivary specimens suited for salivary gland regeneration research. This collection provides a foundation for regenerative therapy development, especially for radiation-induced chronic dry mouth," says Nagarajan Kannan, Ph.D., lead author of the study published in NPJ Regenerative Medicine. Dr. Kannan is also the director of the Mayo Clinic Stem Cell and Cancer Biology Laboratory.

Nearly 70% of patients with head and neck cancer who are undergoing radiation therapy experience permanent damage to their salivary glands. People with this condition experience diminished quality of life from a constant feeling like cotton is lining their mouths. Besides being uncomfortable, chronic dry mouth can lead to difficulties with chewing, tasting, speaking and swallowing. It also can cause tooth decay.

"Chronic dry mouth can extend long after radiation treatments are complete. It's among the top concerns I hear from patients with head and neck cancer. Unfortunately, there aren't many therapeutics available commercially for these patients," says co-author Jeffrey Janus, M.D., an ear, nose and throat specialist at Mayo Clinic in Florida.

One promising avenue of research is the cultivation of rare regenerative cells to greater numbers that can help people someday heal and grow new, healthy salivary gland cells. The biobank consists of specimens collected from 208 donors. From this repository, researchers have already found biomarkers for mature, saliva-producing cells, and with the help of a high-resolution protein map, they have identified the potential tissue origin of rare, self-renewing salivary cells.

The research team also developed a radiation injury model, which paired with the biobank, provides an integrated platform to discover new, personalized regenerative biotherapeutics.

This is a collaboration between Mayo Clinic Center for Regenerative Biotherapeutics, Department of Laboratory Medicine and Pathology and Department of Otolaryngology.

Review the study for a complete list of authors, disclosures and funding. 

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Kelley Luckstein, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic researchers develop first salivary gland regenerative biobank to combat chronic dry mouth appeared first on Mayo Clinic News Network.

September marks the start of soybean harvest in Mankato, Minnesota, a busy time of year when farmers can't afford to be away from their fields for long. So, when Craig Smith, 66, began experiencing a burning sensation while urinating, he went to his family physician right away.

He was prescribed antibiotics, but his symptoms worsened. When Smith began to pass blood, his wife insisted that they drive straight to Mayo Clinic in Rochester — about an hour and a half away. There, Mayo Clinic physicians diagnosed him with metastatic urothelial cancer, or bladder cancer, which had spread to his spine.

Smith recalls receiving a phone call late that night from his Mayo Clinic doctor, who asked him if he wanted to just maintain his health for a few years or cure his cancer.

"I said, 'I'd like you to cure it,'" says Smith.

Seeking a bladder cancer cure

Smith's father had been a farmer, which was his dream too. But his father suggested he gain additional skills to supplement his farming income. Following his father's advice and encouragement from his high school welding teacher, Smith pursued his teaching certificate in welding. What he initially thought would be five or six years of teaching turned into a 45-year career developing welding programs at several local schools while also raising cattle and growing soybeans and corn on his 2,000-acre farm. Through his welding programs, he has trained several welders now employed by local manufacturing companies.

After his diagnosis in 2023, Smith took a hiatus from teaching and farming to focus on his cancer treatments at Mayo Clinic Health System in Mankato, which included chemotherapy, radiation and immunotherapy.

Metastatic urothelial cancer that has spread beyond the bladder usually is considered incurable and inoperable. However, Smith responded well to chemotherapy and radiation to his spine, which made his oncologist, Jacob Orme, M.D., Ph.D., and urologist, Paras Shah, M.D., consider Smith for a new, surgical approach to treatment.

Smith proceeded with the proposed surgery and had his bladder, prostate and 36 lymph nodes removed.

"In Mr. Smith's bladder, we found viable cancer cells that would have led to a relapse. Now, however, he is nearly two years from diagnosis and remains disease-free," says Dr. Shah.

Smith's positive response to treatment and surgery has spurred a clinical trial testing this aggressive approach in other bladder cancer patients. Currently, 17 participants are enrolled, and the results so far have been promising.

Advances in cancer treatment, such as immunotherapy that harnesses the body's immune system to fight cancer and the identification of biomarkers in the blood or urine that show how well a patient is responding to treatment, are helping the physicians select who will benefit most from surgery.

"The impetus for this study is to attack the cancer from multiple approaches, including treatments that cover head-to-toe and treatments that are directed right at the source tumor," says Stephen A. Boorjian, M.D., who is the David and Anne Luther Chair of Urology at Mayo Clinic and a lead proponent of the study.

"We want to remove the root of the cancer after we've burned off the leaves," adds Dr. Orme.

A team of researchers, physicians and clinical trials staff expedited the clinical trial through an accelerated pathway called a Rapid Activation Trial. It's part of a larger effort at Mayo Clinic to launch new clinical trials swiftly and effectively.

"Shortening activation timelines allows us to make a difference to more patients and their families," says Michelle Monosmith, Mayo Clinic Office of Clinical Trials operations administrator.

The study is supported by a generous donation by Ronald J. and Carol T. Beerman to Mayo Clinic and has been prioritized by Dr. Boorjian and Chair of Oncology Elisabeth Heath, M.D., to achieve more cures for men and women with bladder cancer.

"Our only goal is to help our patients live better and longer," says Dr. Orme.

That's what Smith plans to do as he continues to farm, teach and spend time with his family.

The post Farmer inspires new potential bladder cancer treatment appeared first on Mayo Clinic News Network.

Editor's note: May is National Cancer Research Month, and May 20 is Clinical Trials Day.

A cancer diagnosis is an emotional experience. Learning that you have cancer can create feelings of hopelessness, fear and sadness. This is especially true if your cancer is advanced or available treatments are unable to stop or slow its growth.

"Often, when patients are diagnosed with cancer, they feel hopeless and scared. Clinical trials are one way patients can be proactive. They can make a choice in how their care is going to be," says Matthew Block, M.D., Ph.D., a Mayo Clinic medical oncologist.

Cancer clinical trials help physician-scientists test new and better ways to control and treat cancer. During a clinical trial, participants receive specific interventions, and researchers determine if those interventions are safe and effective. Interventions studied in clinical trials might be new cancer drugs or new combinations of drugs, new medical procedures, new surgical techniques or devices, new ways to use existing treatments, and lifestyle or behavior changes.

Clinical trials provide access to potential treatments under investigation, giving options to people who otherwise may face limited choices. "Clinical trials open the door to a new hope that maybe we can fight their cancer back and give them a better quality of life," says Geoffrey Johnson, M.D., Ph.D., a Mayo Clinic radiologist, nuclear medicine specialist and co-chair of the Mayo Clinic Comprehensive Cancer Center Experimental and Novel Therapeutics Disease Group.

You will receive cancer treatment if you participate in a clinical trial. "I think one common misperception about clinical trials is that if you enter a clinical trial, you may not get treatment (receive a placebo). And that's actually very much not true. Most clinical trials are looking at one treatment compared to another treatment," says Judy C. Boughey, M.D., a Mayo Clinic surgical oncologist, chair of Breast and Melanoma Surgical Oncology at Mayo Clinic in Rochester, Minnesota, and chair of the Mayo Clinic Comprehensive Cancer Center Breast Cancer Disease Group.

"I think one common misperception about clinical trials is that if you enter a clinical trial, you may not get treatment (receive a placebo). And that's actually very much not true. Most clinical trials are looking at one treatment compared to another treatment."Judy C. Boughey, M.D.

Watch this video to hear the experiences of people who have participated in cancer clinical trials and to hear Drs. Block, Johnson and Boughey discuss the importance of clinical trials in cancer care:

Clinical trials are a significant part of cancer care at Mayo Clinic Comprehensive Cancer Center. Cancer care teams work together across specialties to make sure the right clinical trials are available to serve the needs of people with cancer who come to Mayo Clinic.

"We are very particular in how we select the clinical trials that we have available for patients," says Dr. Boughey. "We want to have the best trials available for our patients. Some of the clinical trials are evaluating drugs — we are so excited about those drugs, but we can't prescribe those drugs for patients without having that trial. And so we will actually fight to try to get that trial open here to have it available as an opportunity for our patients."

If you choose to participate in a clinical trial, you will continue to receive cancer care. "For most patients that we evaluate, there's always the standard of care treatment option for those patients. And then, in many situations, there's also a clinical trial that the patient can participate in," says Dr. Boughey.

People who participate in clinical trials help make new and better cancer care available for future patients. The treatments available for cancer patients today exist because of the clinical trial participants of yesterday. "We couldn't advance medicine if it wasn't for people volunteering for trials. And the promise from our side is to say we're not going to put patients on trials or offer trials for them to consider unless we think there's a good chance that they'll get a benefit or that society at large will get a benefit," says Dr. Johnson.

"We couldn't advance medicine if it wasn't for people volunteering for trials. And the promise from our side is to say we're not going to put patients on trials or offer trials for them to consider unless we think there's a good chance that they'll get a benefit or that society at large will get a benefit."Geoffrey Johnson, M.D., Ph.D.

Participating in a clinical trial may give you access to cutting-edge treatment, improve your quality of life and extend your time with loved ones.

"It's definitely worth reaching out to your healthcare provider and asking, 'What clinical trials could I be a potential candidate for?'" says Dr. Boughey. "And remember, you can ask this of your surgical oncologist, your medical oncologist, your radiation oncologist, or any of the physicians you're seeing because there are trials in all disciplines. There are also ongoing trials that require the collection of tissue or the donation of blood. They can also be important in trying to help future generations as we continue to work to end cancer."

Participating in a clinical trial is an important decision with potential risks and benefits. Explore these FAQ about cancer clinical trials, and ask your care team if a clinical trial might be right for you.

This article first published on the Mayo Clinic Comprehensive Cancer Center blog.

The post Clinical trials: A significant part of cancer care appeared first on Mayo Clinic News Network.

Mayo Clinic operates one of the largest clinical laboratories in the world. More than 87,000 samples pass through the labs from Mayo Clinic patients and Mayo Clinic Laboratories' clients per day. At Mayo Clinic Laboratories and the Department of Laboratory Medicine and Pathology (DLMP), these thousands of samples are tested for a large swath of molecules that can signal disease. Additionally, Mayo Clinic physicians and researchers develop new diagnostic tests every year. The innovation and capability to improve medicine fuels the work of clinical pathologist Akhilesh Pandey, M.D., Ph.D. 

"The fact that we, as researchers, can find a new biomarker associated with a disease, develop a test to find it sooner and implement it into clinical practice, places Mayo Clinic at the forefront of the medicine of the future," he says.  

Dr. Pandey's multidisciplinary research team consists of chemists and biochemists, molecular and computational biologists and experts in advanced biomedical instrumentation who push the boundaries of technology to develop more powerful tests to help detect and diagnose diseases earlier.

"Our lab is focused on problems and technologies where there is a direct and tangible path to discovering new findings that can be put into medicine in many ways, especially in terms of diagnostics. For us, it's all about translating research into the practice," he says.

He collaborates with more than 100 different researchers at Mayo Clinic to achieve this.

"DLMP consultants and staff are continually searching for ways to translate clinically relevant research findings into novel diagnostics that will provide our clinicians and patients the answers they need. Many of these findings come from our own investigators in DLMP or Mayo Clinic, but we also will keep abreast of advances from researchers worldwide. Our track record is impressive due to the efforts and creativity of consultants like Dr. Pandey and so many others," says Eric Hsi, M.D., chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic.

Research and Practice 

One group of genetic disorders that is particularly challenging to diagnose is called sphingolipidosis, which stems from the harmful accumulation of sphingolipids, a type of lipid molecule. Tay-Sachs disease is a form of sphingolipidosis where these lipids build up in the brain and spinal cord, causing nerve cell damage.

Most tests for sphingolipidosis can only screen for one specific form of the disorder at a time, targeting about 10 molecules, which makes the process laborious and time-consuming for both clinicians and patients. 

Dr. Pandey and researcher Seul Kee Byeon, Ph.D., heard about this challenge from colleagues in Mayo Clinic's Department of Laboratory Medicine and Pathology. So they went to work designing a more efficient test.

The result: a single assay that can test for 47 different molecules linked to many kinds of sphingolipidosis, offering more efficient diagnostic testing.  

"It's a huge gain, especially for clinicians who may suspect a patient has a rare and serious genetic condition but may not know where in the pathway the problem lies," says Dr. Byeon, who is the lead author on a study reporting the findings in the journal Clinical Chemistry.

This new test is still in development but will be rolled out for use in the near future at Mayo Clinic Laboratories. Dr. Byeon is also working on the next iteration of this assay, which would target hundreds of lipids. 

From just one cell

Dr. Pandey's research teams in the Systems Biology and Translational Medicine Laboratory and the Advanced Diagnostics Laboratory use a sensitive but versatile technique called mass spectrometry to detect, identify and quantify molecules in lab samples, which can come from blood, tissue or other specimens.

In addition, Dr. Pandey's team conducts research using single-cell proteomics and single-cell lipidomics, which can uncover what proteins and lipids, respectively, are present in individual cells. They also apply a rapidly evolving approach called spatial biology to map where various molecules are in a specific tissue. 

The information gleaned from these analytical techniques can lead to the discovery of biomarkers for a variety of conditions, from genetic disorders to cancer. 

"We want to find the next generation of biomarkers and we have the technology to do it," he says. 

Dr. Pandey's multidisciplinary research team has several other notable projects underway aimed at advancing diagnosis and treatment for a variety of diseases and disorders including: 

• Multiple myeloma: Working to identify which patients with this blood cancer will respond to a certain class of drugs that stimulates the immune system to attack abnormal cells.
• Cholangiocarcinoma: Helping gastroenterologists detect this form of bile duct cancer using single-cell proteomics, which illuminate protein behavior in individual cells, with the goal of detecting this difficult-to-treat cancer earlier.
• Inherited metabolic disorders: Adapting a blood-based test that detects genetic defects in a complex chemical process known as glycosylation so that it can be used to detect metabolic changes associated with cancer. 
  

Review the studies for a complete list of authors, disclosures and funding.

The post Advancing medicine one lab test at a time appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — A new study by Mayo Clinic Comprehensive Cancer Center researchers found that the presence of a specific genetic mutation — KRAS circulating tumor DNA (ctDNA) — strongly indicates a higher risk of cancer spread and worse survival rates for patients with pancreatic ductal adenocarcinoma (PDAC). The mutation was identified using a readily available and clinically approved blood and abdominal fluid test.

PDAC is an aggressive form of cancer that is often difficult to diagnose. Most patients already have cancer spread to other parts of their body when initially diagnosed, and current tests often miss this hidden spread. This makes it challenging to determine the best treatment strategy. The findings, published in the Annals of Surgical Oncology, may help identify patients who are more likely to have cancer spread to other parts of the body, therefore providing doctors and patients with the right information to make informed decisions about treatment.

"This is a major advancement for pancreatic ductal adenocarcinoma," says Mark Truty, M.D., hepatobiliary and pancreatic surgical oncologist within Mayo Clinic's Department of Surgery. Dr. Truty is senior author of the study. "We've had this genetic testing available for a number of years, however, we did not know the significance of the results or how to interpret them. Having the KRAS status will allow the patient and their provider to make better decisions about their individual cancer treatment."

The prospective cohort study, involving nearly 800 patients — the largest patient series to date in the literature using ctDNA — found that 20%-30% of patients with PDAC have detectable mutant KRAS ctDNA in the blood and/or peritoneum, and that those without any previous treatment, such as chemotherapy, had the highest incidence. Thus, the study suggests that ctDNA assays should be performed prior to treatment to have the highest yield.

The researchers examined data between 2018 and 2022. Blood sample tests revealed that 104 patients (14%) had KRAS ctDNA mutation. These patients were more likely to develop advanced, spreading cancer and had a lower survival rate. Further testing of fluid from around the abdominal cavity in 419 patients showed similar results: 123 (29%) had the marker, and these patients also experienced worse outcomes. The presence of this marker, whether in blood or abdominal fluid, indicated a poorer prognosis.

The study highlights that while surgery is the only known cure, most patients experience cancer spread after surgery. The test helps identify patients less likely to benefit from surgery alone, guiding treatment decisions towards chemotherapy and/or radiation before surgery. For patients without the KRAS mutation (approximately 10% of cases), the test is less conclusive and other tests are needed.

"Historically, we've known that KRAS mutations are associated with a more biologically aggressive pancreatic cancer," says Jennifer Leiting, M.D., hepatobiliary and pancreatic surgeon within Mayo Clinic's Department of Surgery. Dr. Leiting is first author of the study. "But this large study gives us a much clearer understanding of how to interpret the test results and use them to improve patient care. It allows for more accurate staging at diagnosis, leading to better treatment decisions."

The researchers suggest that this test should become a standard part of the initial diagnosis for PDAC, enabling more personalized risk stratification and effective treatment plans.

"This improved diagnostic capability offers hope for patients and their families facing this challenging disease," says Dr. Truty. "It's optimistic to see how advances in genetic testing are directly helping our patients."

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About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. 

About Mayo Clinic Comprehensive Cancer Center 
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

• Kelley Luckstein, Mayo Clinic Communications, newbureau@mayo.edu

The post Mayo Clinic researchers identify a measurable genetic mutation as a significant predictor of metastasis and survival in pancreatic cancer appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — A discovery by Mayo Clinic researchers may help explain why immunotherapy hasn't been helpful for many patients with metastatic colorectal cancer. In findings published in Clinical Cancer Research, the team identified specific proteins — fibronectin and smooth muscle actin — within colorectal cancer tissues that are associated with resistance to immunotherapy treatment.

Immunotherapy is a major advance in treating cancer, but many patients, including those with metastatic colorectal cancer, do not respond to it. Until now, researchers have not known why.

"We need predictive biomarkers to guide the selection of immunotherapy for patients," says medical oncologist and gastroenterologist Frank Sinicrope, M.D., the senior author of the study. "Identifying those who may have resistance to treatment can be useful, because then we can spare them from receiving treatment that may not be beneficial and could produce significant toxicities."

The research team used digital spatial profiling, an advanced technology that simultaneously analyzes the expression of multiple proteins and where they are located within tissues. This approach allowed researchers to zoom in to get a bird's eye view of a tumor that includes proteins both within and surrounding the tumor cells and how they interact.

Dr. Sinicrope compares the spatial tools to an aerial view of a neighborhood where one can see relationships between driveways, houses, yards and neighboring structures. Similarly, this detailed view provides physicians and researchers with critical information about the proteins in and around a patient's cancer, potentially informing the best treatment for the patient. 

"We wanted to learn more about the patients who did not respond to immunotherapy. We investigated the leading edge of the tumor where cancer cells are invading and where the immune system is attempting to fight the cancer," says Dr. Sinicrope. "It's like a battle going on here and we're getting a snapshot into who is in attendance."

The researchers focused on 10 regions at the invasive margin of a tumor. They applied digital spatial profiling to investigate 71 distinct proteins in both the tumor's epithelial compartment and the surrounding stromal compartment. Fibronectin and smooth muscle actin are two extracellular matrix proteins that were found in the epithelial region of the tumor and were associated with resistance to immunotherapy and shorter time before disease progression.

Upon further analysis, the researchers observed that cancer-associated fibroblasts were producing these proteins. The evidence, they say, suggests that these proteins can contribute to suppression of the anti-tumor immune response.

The discovery offers a step toward more personalized and effective colorectal cancer treatments.  

Review the study for a complete list of authors, disclosures and funding.

### 

About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. 

About Mayo Clinic Comprehensive Cancer Center 
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:  

• Kelley Luckstein, Mayo Clinic Communications, newsbureau@mayo.edu  

The post Mayo Clinic researchers identify proteins linked to immunotherapy resistance in metastatic colorectal cancer appeared first on Mayo Clinic News Network.