Combining medicine, engineering and computer science, a new approach from Israel can detect — in real time — any cancer cells left in the abdominal cavity after a malignant tumor is removed surgically.

The breakthrough comes from a research team at Tel Aviv University’s Zimin Institute for Engineering Solutions Advancing Better Lives, led by Prof. Noam Shomron and doctoral student Artem Danilevsky.

Shomron explains that often there are undetected cancer cells remaining after tumor removal. Because those cells can spread throughout the body, the patient must undergo chemotherapy treatments to kill them.

The problem is that the critical time frame between the surgery and the cancer cell detection lab tests results can be several weeks long, a delay which drastically increases the risk for a renewed cancer spread.

The new tool developed by Shomron and Danilevsky is based on a genetic sequencing device called MinION, produced by Oxford Nanopore Technologies. MinION allows doctors and patients to receive results in minutes to several hours.

The researchers take a blood and an abdominal cavity fluid sample while the patient is having the tumor removal surgery. The samples are inserted into the MinION device, which, using a unique algorithm developed by the Israeli researchers, can tell whether the sample is more like that of a healthy person or a cancer patient.

Potentially lifesaving

This simple but smart application of an existing technology has successfully been implemented in a preliminary pilot program at Tel Aviv Sourasky Medical Center (“Ichilov Hospital”).

“We wait outside Dr. Guy Lahat’s operating room at Ichilov. During the surgery, Dr. Shelly Loewenstein collects a small part of the abdominal cavity fluid sample for us. The sample itself is sent simultaneously to the standard lab test. The lab test results arrive after a few weeks. Meanwhile, we insert our sample into the MinION and calculate whether it contains cancer cells or healthy ones. It’s a lot less complicated than sequencing the whole genome,” said Shomron.

“If the results turn out positive, Dr. Lahat continues with a designated abdominal cavity chemotherapy treatment. Afterwards, he performs a saline washing, takes another sample and repeats the cycle again, until we ensure that the patient is free of cancer cells.”

This is potentially a lifesaving medical treatment, predicted Shomron.

The researchers stress, however, that the implementation of the novel device is still in its initial trial stages and more time is required until the new device will reach the precision level of older, slower and larger devices.

In addition, Shomron estimates that in several years it might be possible to expand the implementation of this novel technology to detect cancer cells with a simple blood test during everyday life and not only during a surgery.

He explained that the Zimin Institute was searching for an engineering application to improve lives.

“They asked for novel and unique projects. Projects that would not get funding from any other foundation but will be implementable. We combined several research areas in order to offer a smart and fast diagnostic tool, but there were no ‘buyers.’ We went through various hospital divisions and asked the doctors ‘Who wants a DNA test done in an hour?’

“Fortunately, we found Dr. Lahat, director of the Division of Surgery at Ichilov, who jumped on the opportunity to shorten and improve diagnostic processes for the benefit of cancer patients.”