Physician-scientist is using CF grant to develop personalized blood test for chordoma patients
Because chordoma is such a rare cancer, most doctors-in-training never even come across it during medical school or residency. But because Dr. Chetan Bettegowda went to Johns Hopkins University for his training, he had an uncommon opportunity to learn about this uncommon cancer.
“Johns Hopkins is one of a handful of high-volume centers for caring for patients with chordoma,” says Bettegowda, who earned medical and doctoral degrees at JHU and joined the neurosurgery and oncology faculty in 2012. “While working with our neurosurgeons and patients and discussing different research questions and opportunities, I became interested in chordoma as well.”
Bettegowda provides medical and surgical care for adults with brain tumors and other neurological disorders. He also pursues research focused on tumors that affect the brain, spine and central nervous system. In late 2013, he received a $50,000 seed grant from the Chordoma Foundation toward his efforts to develop a personalized blood test for chordoma patients. If successful, this test could potentially detect recurrences, metastases, progression, or response or resistance to therapy sooner and with greater sensitivity than existing imaging technologies.
“A few types of tumors have markers in the blood that clinicians can use to see changes in the tumor over time – PSA for prostate cancer, for instance,” Bettegowda explains. “Unfortunately, the vast majority of tumor types, including chordoma, do not have such a marker, making it difficult to determine whether a tumor is responding to treatment, or is returning.”
Bettegowda’s goal is to develop a blood test that is specific to each person’s tumor. “Using very sensitive molecular biology techniques, we can detect and quantify fragments of mutated DNA spilled by the tumor into the bloodstream. For example, we could measure the amount of this DNA present in a patient’s blood in January, and then again in June. If the amount increased dramatically, we would be concerned that the tumor was growing or recurring. Conversely, if the amount had decreased, we would be hopeful that the tumor was getting smaller and responding to therapy.”
The research is still at its earliest stages, Bettegowda notes. “One challenge with a rare disease like chordoma is getting enough tumor samples to ensure the lab results are reproducible, reliable and clinically significant. We’re starting with samples we’ve accrued here at JHU; if our results appear promising, we plan to reach out to collaborators through the Chordoma Foundation to broaden these studies.”
When not in the clinic, operating room or lab, Bettegowda is busy with his wife and two young sons. In each of these venues, he often draws on his undergraduate experiences at Duke, where he double-majored in biology and religion.
“I enjoyed grounding the science of biology with something a bit more philosophical and thought-provoking,” he says of his combined majors. “Most religions espouse the fundamental principles of trying to lead a good life, and I think you can apply those lessons to any role: as a physician, a scientist, a father, a husband, or a friend.”