Dr Jamie Bakkum-Gamez on Developing an Early Detection Test for Endometrial Cancer

Jamie Bakkum-Gamez, MD, associate professor of obstetrics and gynecology and Gynecologic oncologist at Mayo Clinic, discusses her research on developing an early detection test for endometrial cancer.

Transcript

What sort of novel approaches did you research to assist in the early detection of endometrial cancer?

One of the projects that I’ve been working on from the research side of things since I came on staff at Mayo clinic is the development of an early detection test for endometrial cancer.

In gynecology, we’ve had huge success when it comes to screening for cervical cancer with the PAP test and PAP+HPV, but we do not have a screening test for endometrial cancer. Endometrial cancer is now the most common gynecologic malignancy that we care for in the United States. One in 50 women will develop an endometrial cancer and when they come in to see me, oftentimes the question that I get asked is, “My pap smear was normal…how could I have cancer and have a normal pap smear?”

Well the pap smear is not a test that is designed to pick up endometrial cancer. In fact, the sensitivity of a PAP test to pick up abnormal cells that indicate endometrial cancer up inside the uterus is only about 30%. But we know that there are molecular markers that are shed from cancers into other biospecimens— whether it’s peripheral blood, or other downstream biospecimens.

So, the biospecimen that we have been focusing our research on is that of the vaginal pool. The vaginal pool is defined as everything that comes from up in the female reproductive tract and flows down into the vagina. This could be fluid and material that comes from the fallopian tubes, maybe even the ovaries— there’s actually some data out there that suggests that mutations that arise in ovarian cancer can actually be detected in samples from the vagina and cervix, so we know that there is some downstream targeting of that. Also, fluid from the endometrium cavity, the cervix and the vagina. So, all of that is what’s in the vaginal pool.

What we’ve been doing is trying to design an early detection test using a tampon as the tool for collecting that biospecimen. In that biospecimen we look for molecular markers such as methylation or mutations. Similar to the most recent paradigm shift in colorectal cancer screening, which is that of the stool-based test called cologuard, we aim to develop a multi-panel/multi-marker test that will pick up endometrial cancer or endometrial cancer precursers. [This would] allow women to have the diagnosis earlier, ideally, and allow better access to care because this would be a test or a specimen that could be collected from the comfort of our patient’s own bathroom.