Liver cancer – or hepatocellular carcinoma (HCC) – is the sixth most common cancer and the third leading cause of cancer-related deaths worldwide. Men are almost three times more likely to develop HCC than women, and Louisianans suffer some of the highest HCC incidence and mortality rates in the nation.

At one time, Hepatitis C (HCV) viral infection was the primary cause of chronic liver disease, cirrhosis and liver cancer in the United States, and it was the leading cause of liver transplant. But in 2014, a new direct-acting antiviral was approved for the treatment of HCV and incidence rates of HCV-associated liver cancer began to decrease.

"But the most prominent non-viral etiologies of cirrhosis and HCC – chronic alcohol consumption, non-alcoholic fatty liver disease and type 2 diabetes – remain," said Srikanta Dash, PhD, professor of pathology and laboratory medicine. "And recent projections estimate that HCC incidence will increase worldwide among an aging population with metabolic syndrome, diabetes and toxic environmental exposure."

One of the key factors contributing to its high mortality rate is that an alarming majority of HCC cases are detected at a late stage when treatment options are severely limited. "Early detection improves liver cancer prognosis and increases treatment success rates, and so people with cirrhosis should undergo regular screening," said Dr. Dash.

Current screening options include imaging tests like ultrasounds, CT scans and MRIs plus an alpha-fetoprotein blood test. "But the sensitivity and specificity of these tests are not always adequate and they are often expensive," said Dash. "There is an urgent need for the development of serum-based biomarkers – that can be identified through a simple blood test – to detect cirrhosis and cancer at an early stage."

With support from a Veterans Affairs Merit Review Grant, Dash and his colleagues in Tulane's Department of Gastroenterology and Hepatology and at Ochsner Health's Institute of Translational Research and Multi-Organ Transplant Institute are investigating whether extracellular vesicles (EVs) released from HCC tumor cells could be a candidate.

EVs are nanometer-sized, enclosed lipid particles naturally released by most cells in the body. EV release is controlled through autophagy, a type of cellular cleaning process during which the cells break down and recycle or expel their old or damaged components. This process is essential for a cell to survive and function optimally. Through previous research, Dash and his team learned that most HCC tumors developed in the cirrhotic liver have an impaired autophagy process, causing them to release more undegraded EVs into the blood stream.

"This led to our hypothesis that if we can selectively capture liver-derived vesicles coming from the HCC tumor in the blood, then it could be a potential biomarker for early HCC detection," said Dash.

But how do you isolate and quantitate these particles? In their recent study, published in the Journal of Hepatocellular Carcinoma, Dash and his colleagues report on their use of the NanoSight NS300 – an instrument developed for the scientific tracking and analysis of nanoparticles – to fluorescently illuminate and quantify HCC-derived EVs in blood samples.

"We used antibodies that target proteins selectively expressed by HCC tumors to help us identify and quantify the HCC-derived EVs," said Dash. "When the blood sample is run through the lasers and filters in the NanoSight, the EVs fluoresce and literally light up our computer screens." His data showed an increased quantity of EVs in HCC samples compared to samples from patients with malignancy-free cirrhosis, as well as a positive correlation between MRI-confirmed total tumor size and EV concentration. These results tend to validate the possible use of fluorescence nanoparticle tracking analysis in the early detection of liver cancer.

Dash believes this process could also assist physicians in determining whether treatments are working. "If you see a decrease in the quantity of fluoresced EVs as the patient is being treated, it could be an indication that the tumor is shrinking and the treatment is working," said Dash.

Next steps for Dash and his team are to develop clinical trials to further test the accuracy of this technology in the early detection of HCC. He also plans to use the same techniques to quantitate premalignant vesicles in an effort to develop biomarkers for chronic and fibrotic liver disease so physicians can treat these conditions at much earlier stages and possibly prevent their development to cirrhosis and HCC.

Bill Wimley, the George A. Adrouny, PhD Professor in Biochemistry in the Department of Biochemistry and Molecular Biology in the Tulane School of Medicine, has been awarded a grant of $1.6 million from the National Institute of General Medical Studies to study nanopore technology. 

Before joining Tulane, Seanne was the Executive Director for Administration of the NCI-designated comprehensive University of California, San Diego – Moores Cancer Center. While there, she led the development of an integrated research and clinical operations strategic plan for the cancer center and restructured the grants management and financial analytics group. She led teams charged with the oversight of all research administrative operations, including finance and grant management, laboratory and office space management, shared resources, research development, marketing and communications, training and education, and the development of novel programs and initiatives. 

Seanne has also served as Executive Director and Associate Director for Administration at the NCI-designated comprehensive University of Minnesota Masonic Cancer Center, where she helped launch the Minnesota Cancer Clinical Trials Network to improve cancer outcomes through greater access to cancer clinical trials throughout the state. She began her career in academic healthcare at Harvard Medical School as the Chief of Staff of the Harvard Catalyst |The Harvard Clinical & Translational Science Center and then as the Director of Harvard Catalyst Clinical Research Center Operations. Her early career in accounting and corporate finance with General Mills in Minneapolis, MN, provided her with a solid foundation and a keen understanding of financial management—an asset she continues to leverage in her leadership roles.

She holds a Bachelor of Business Administration degree from the University of Wisconsin – Madison, with dual majors in accounting and human resources / management, a Master of Business Administration from the Yale School of Management, with a concentration in nonprofit management, and a Master of Science in Health Sciences with a focus on clinical operations and healthcare management from The George Washington University School of Medicine and Health Sciences.

She is a Fellow of the American College of Healthcare Executives and an advisory board member for After Cancer – Solutions for Sexual Health. She also has served as a business and agriculture development volunteer in the Peace Corps - Moldova and a collegiate challenge coordinator for Habitat for Humanity here in New Orleans in 1999.

“Seanne brings a wealth of experience in strategic planning and cancer center administration to her new role at Tulane,” said Stefan Grant, MD, JD, MBA, interim director of the Tulane Cancer Center. “We look forward to her insight and contributions in further developing the Tulane Cancer Center as part of the Louisiana Cancer Research Center.”

Members of Krewe de Pink – a New Orleans-based 501c3 organization dedicated to raising funds for breast cancer research –recently presented Tulane Cancer Center with a check for $45,500, representing the results of their fundraising efforts in 2023.

"Krewe de Pink's dedication to this cause has and will continue to meaningfully impact the course of breast cancer research here at Tulane and beyond," said Stefan Grant, MD, JD, MBA, interim director of the Tulane Cancer Center. "I can’t thank them enough for being our most dedicated and enthusiastic friends and partners in progress and for investing so generously in our shared mission to make new inroads into detecting, treating and curing breast cancer."

Krewe de Pink is dedicated to producing events with a quirky "New Orleans flair" and host several unique annual fundraisers that generate the dollars they donate. Add these to your 2024 calendar and join the fun this year:

For more information on Krewe de Pink or any of their signature events, please visit www.krewedepink.org.

Every day thousands of cancer patients need a ride to treatment, but some have no way to get there. The American Cancer Society's Road To Recovery program fills this gap by providing transportation to and from treatment appointments for patients who do not have a ride or are unable to drive themselves.

But the program depends on its volunteer drivers in order to provide this vital service, and "right now the ACS is in need of additional Road to Recovery drivers in the New Orleans area," said Lexie Matherne, associate director for community implementation at the American Cancer Society - Louisiana.

If you own or have regular access to a safe, reliable vehicle, then you’re already on the road to volunteering. Volunteer drivers must be between the ages of 18 and 84, have a valid driver’s license, pass a background check, and have access to a safe, reliable car. To learn more about becoming a Road To Recovery^® volunteer, please visit the ACS's Road to Recovery^® volunteer page here or contact Lexie Matherne at [email protected] or 225.465.7457.