Cancer treatments have come a long way, offering hope to millions of patients.
One major breakthrough is the use of immune checkpoint inhibitors (ICIs), a type of therapy that helps the immune system attack cancer cells.
But while ICIs are powerful, they can also cause serious side effects. One rare but dangerous condition is ICI-related myocarditis—an inflammation of the heart that can be fatal in up to 40% of cases.
This side effect happens when the immune system becomes too aggressive and begins attacking healthy heart tissue. White blood cells and other immune cells flood into the heart, causing damage.
Diagnosing this heart condition early is critical because prompt treatment can help prevent serious harm or death.
However, detecting ICI-related myocarditis has been a major challenge. It’s not easy to spot using regular heart imaging, and taking a tissue sample (biopsy) from the heart is risky.
To solve this problem, a team of researchers at Stanford University, led by Dr. Alireza Raissadati and Dr. Sean Wu, has developed an innovative new test.
Their approach uses a simple blood draw to analyze cell-free mRNA—a type of genetic material that floats freely in the bloodstream. Their findings were recently published in the Journal of Clinical Investigation.
What makes this method so special is that cell-free mRNA can provide very detailed information, even showing changes happening in specific tissues like the heart or in particular types of cells like immune cells. Other types of blood-based tests—such as those looking at proteins, DNA, or microRNAs—do not offer the same level of detail.
By studying cell-free mRNA in blood samples, the team could detect signals from both immune cells attacking the heart and heart muscle cells releasing mRNA due to damage. This means doctors could spot the signs of ICI-related myocarditis much earlier than with traditional methods.
The researchers tested their method on 22 patients who developed myocarditis after receiving ICI cancer therapy. They successfully gathered enough mRNA from blood samples in every case to conduct the analysis.
They also identified a group of genes that were more active in patients with this condition. Using machine learning, they further refined their test to pick out the key gene expression changes linked to the immune response and heart damage.
This new mRNA blood test, often called a liquid biopsy, shows great promise. It could make it much easier to detect heart problems caused by cancer treatments before they become life-threatening. By using this approach, doctors could act earlier to adjust treatments and protect patients from serious complications.
Overall, this study opens up exciting new possibilities for safer cancer care and better monitoring of treatment-related risks using advanced, non-invasive testing.
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The study is published in Journal of Clinical Investigation.
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