Testing Your RNA with Liquid Biopsies”

“Testing Your RNA with Liquid Biopsies” (Alex Rolland) [#116] Brad Power October 16, 2024 “You may have heard about the exciting new world of exosomes. Exosomes are membrane- bound vesicles (small sacs filled with fluid). They're excreted by cells, and all cells use them to communicate. More importantly, they're used by cancer cells.

Cancer cells will spread their mutations and their altered DNA and their transcribed RNA and all of their different molecular mechanisms are found in cancer-causing exosomes.” – Alex Rolland “It's really important to use as many different tests as possible. Education is power. Knowledge is power. The more different platforms we have to look at, the better.

Each one of these platforms is slightly different.” – Alex Rolland Meeting Summary Time pressures and money constraints can cause you and your medical team to miss out on the latest advancements in new, effective diagnostic tests. For example, the use of RNA testing is increasingly being considered as a useful diagnostic test (beyond scans and DNA testing).

Scans (ultrasounds, X-rays, MRIs, and CT scans) can only spot tumors that are larger than 0.8 cm. Sometimes these scans find areas that seem "suspicious" or "high risk," but they can’t tell for sure if they are cancer tumors. In these cases, doctors often use a “watch and wait” approach, tracking whether the area grows.

But focusing only on the size and density of the tumor can mean missing early chances to detect and treat cancer. Alex Rolland, Chief Research Director and co-founder of Cancer Treatment Options and Management is uniquely qualified to talk about a new test that offers additional capabilities: RNA testing using liquid biopsies.

He is passionate about ensuring that anyone who receives a cancer diagnosis has access to the most effective and least invasive forms of testing and treatment possible. Alex holds a BSc in Molecular/Cell Biology from the University of Victoria, and studied Medical Genetics at the Terry Fox Laboratory in Vancouver (BC Cancer Agency).

With over a decade of experience researching, consulting, and advocating for cancer patients, Alex also works directly with the medical system to explore the newest optimal treatments for his clients. He’s an expert in discovering how to optimize your cancer treatment, and making this a reality for you. Why might you want to learn about liquid biopsies that look at RNA in exosomes?

Ideally cancer can be detected early, before it forms a visible tumor. Liquid biopsy (blood or other liquid) tests that look at tumor exosomes (small, membrane-bound sacs filled with fluid) can find cancer activity early, leading to faster detection and better treatment outcomes. An exosome is a tiny bubble-like structure that cells release.

These bubbles carry various molecules, such as proteins, DNA, and RNA, from one cell to another.

“Testing You

and better treatment outcomes. An exosome is a tiny bubble-like structure that cells release. These bubbles carry various molecules, such as proteins, DNA, and RNA, from one cell to another. Exosomes play an important role in cell communication and can be found in body fluids like

“Testing Your RNA with Liquid Biopsies” (Alex Rolland) [#116] blood, urine, and saliva. Scientists can use exosomes to study what's happening inside the body without needing a traditional tissue biopsy. Exosomes are produced by the cancer cell as soon as it is transformed. The process of metastasis starts well before a tumor is even detectable.

By the time a tumor is 1 cm, it has a billion cells, and there are tumor cells all over the body. When cancers are detected at an early stage, you have fewer different kinds of cancer cells (“heterogeneity”), and they will not have spread as widely throughout your body.

Your test should also ideally identify your specific molecular drivers in real time and understand how your genes are being turned on and off (“epigenetic regulation”). What are the benefits of exosome-based liquid biopsies? ●Detect if there is cancer activity happening before there's a visible tumor. ●Detect if you are responding to therapy in real time.

●Determine what RNA molecules are highly overexpressed that are involved in driving the cancer at that given moment (possibly pointing to a targeted therapy). ●Determine drug response very quickly – by seeing if there are a lot of exosomes or not.

●Detect “pseudo-progression” – if you are on an immunotherapy, the immune cells can enter your tumor and make your tumor look bigger, but they're actually eating them from the inside out. It’s hard to detect with imaging, but there will be a low amount of exosomes in the body if you are responding to immunotherapy.

●Detect emerging treatment resistance over expressed oncogenes for targeted therapies. How does this liquid biopsy exosome test differ from other liquid biopsy tests? Most liquid biopsy tests use circulating tumor DNA. They are designed for detecting emerging DNA mutations.

They're not designed for detecting the level of the actual mutation in the blood, because they are not looking at the exosomes. The exosomes are a cancer-specific mechanism, and by isolating the exosomes, you're looking at exactly what the cancer is doing, and you're getting the relative amount of that mutation in the blood. Some other companies are looking at genes expressed through RNA.

Some of them are doing it from exosomes. But the problem is the panel that they're using is designed for detecting mutations, and it's not accurate for detecting expression. RNA gets degraded significantly once you take it out of the body.

Therefore, you can't always tell what was actually produced by the tumor there if you're not looking specifically at the exosomes and looking at a gene panel or an expression panel designed specifically for expression.

r detecting expression. RNA gets degraded significantly once you take it out of the body. Therefore, you can't always tell what was actually produced by the tumor there if you're not looking specifically at the exosomes and looking at a gene panel or an expression panel designed specifically for expression. Is this exosome test a good fit for you?

“Testing Your RNA with Liquid Biopsies” (Alex Rolland) [#116] Exosomes are only typically released in high numbers if your cancer is metastatic. If you are responding to therapy, or are in remission, you won't see a lot of these exosomes. How can you get these exosome tests? You can order this test yourself. (You don't need a doctor to order this for you.) The cost is about $1500.

There are a couple of websites for access: ●The Cancer Treatment Options and Management site offers a research and analysis team and a patient navigation program. It includes experts like Alex who analyze the test data and make sure it's utilized to your best advantage. There are navigators who help with access.

They coach you on the language to use with your oncologist to get better uptake, and on the back end with all the programs and the paperwork. ●At Liquid Biopsy Labs you can order the specific test, if you don’t want the other services. How can you learn more about RNA testing and other key elements of personalized treatment?

●Book a one-on-one cancer care consultation on testing and treatment options ●Join the free precision cancer medicine education and advocacy program : “Cancer – Just The Facts” with video lessons, downloadable .

pdfs and live question and answer video sessions ●Join the Facebook community Cancer Treatment Options and Management ●Visit Alex’s YouTube channel, “The Cancer Guy” ; subscribe to stay informed (new videos every week) ●Review sample reports of the liquid biopsy test ●Review formal research on the liquid biopsy test once the commercialization process is complete ●Contact Alex at contact@ctoam.

com The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action.

You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health.

“Testing Your RNA with Liquid Biopsies” (Alex Rolland) [#116] Meeting Notes KEYWORDS liquid RNA, cancer diagnosis, exosomes detection, precision oncology, tumor suppressors, oncogenes, epigenetic regulation, molecular drivers, pseudoprogression, hyper progression, liquid biopsies, RNA expression, tumor cells, pathology reports, direct-to-consumer SPEAKERS Alex Rolland (63%), Brad Power (18%), Michelle Morand (15%), Brian McCloskey (4%) CHAT

on. RNA gets degraded significantly once you take it out of the body. Therefore, you can't always tell what was actually produced by the tumor there if you're not looking specifically at the exosomes and looking at a gene panel or an expression panel designed specifically for expression. Is this exosome test a good fit for you?

“Testing Your RNA with Liquid Biopsies” (Alex Rolland) [#116] Exosomes are only typically released in high numbers if your cancer is metastatic. If you are responding to therapy, or are in remission, you won't see a lot of these exosomes. How can you get these exosome tests? You can order this test yourself. (You don't need a doctor to order this for you.) The cost is about $1500.

There are a couple of websites for access: ●The Cancer Treatment Options and Management site offers a research and analysis team and a patient navigation program. It includes experts like Alex who analyze the test data and make sure it's utilized to your best advantage. There are navigators who help with access.

They coach you on the language to use with your oncologist to get better uptake, and on the back end with all the programs and the paperwork. ●At Liquid Biopsy Labs you can order the specific test, if you don’t want the other services. How can you learn more about RNA testing and other key elements of personalized treatment?

●Book a one-on-one cancer care consultation on testing and treatment options ●Join the free precision cancer medicine education and advocacy program : “Cancer – Just The Facts” with video lessons, downloadable .

pdfs and live question and answer video sessions ●Join the Facebook community Cancer Treatment Options and Management ●Visit Alex’s YouTube channel, “The Cancer Guy” ; subscribe to stay informed (new videos every week) ●Review sample reports of the liquid biopsy test ●Review formal research on the liquid biopsy test once the commercialization process is complete ●Contact Alex at contact@ctoam.

com The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action.

You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health.

“Testing Your RNA with Liquid Biopsies” (Alex Rolland) [#116] Meeting Notes KEYWORDS liquid RNA, cancer diagnosis, exosomes detection, precision oncology, tumor suppressors, oncogenes, epigenetic regulation, molecular drivers, pseudoprogression, hyper progression, liquid biopsies, RNA expression, tumor cells, pathology reports, direct-to-consumer SPEAKERS Alex Rolland (63%), Brad Power (18%), Michelle Morand (15%), Brian McCloskey (4%) CHAT Allen Morris, Stratis Telloglou

ogenes, epigenetic regulation, molecular drivers, pseudoprogression, hyper progression, liquid biopsies, RNA expression, tumor cells, pathology reports, direct-to-consumer SPEAKERS Alex Rolland (63%), Brad Power (18%), Michelle Morand (15%), Brian McCloskey (4%) CHAT Allen Morris, Stratis Telloglou, Roger Royse, Ari Akerstein, Rick Davis, Ryan Ramanujam, Jane Wilkinson, Brian McCloskey, Chris Apfel, Eric Dishman SUMMARY Alex Rolland discussed the potential of liquid RNA as a diagnostic tool for cancer, emphasizing its role in detecting early-stage cancer and real-time molecular drivers.

He explained the mechanisms of “oncogenes”, “tumor suppressors”, and “transcribed RNA”, and highlighted the benefits of exosome-based liquid biopsies, including rapid drug response detection and identifying pseudo-progression. He noted the limitations of current tests, such as circulating tumor DNA (ctDNA) and RNA panels, which often lack specificity and accuracy.

He also discussed the importance of pathology and the use of laser capture microdissection to isolate tumor cells for precise analysis. The test costs $1,500 and is available directly to consumers. OUTLINE Introductions ●Alex Rolland was recommended to the Cancer Patient Lab by Roger Royse, who found Alex's advice helpful in his cancer journey.

●Alex introduced his partner, Michelle Morand, who is the operational leader in their company, Cancer Treatment Options and Management. Cancer Basics and Personalizing Cancer Care ●Alex introduced the basic mechanisms of cancer and the importance of targeting these mechanisms in personalized cancer care.

●“Oncogenes” (a mutated gene that can cause cancer by causing cells to grow and divide uncontrollably), “tumor suppressors” (also known as anti-oncogenes, genes that regulate cell growth and division to prevent cancer; when they are mutated, they can no longer control cell growth, which can lead to cancer.

), and “transcribed RNA” (or the RNA transcript, the RNA strand produced when a gene is copied from DNA into RNA) have roles in cancer development.

“Testing Your RNA with Liquid Biopsies” (Alex Rolland) [#116] ●There are many challenges in cancer detection, including late-stage detection and identifying molecular drivers in real-time. ●“Epigenetics” describes how genes turn on and off to create different cell types. Environmental and behavioral factors can impact how genes function without changing the DNA sequence.

Epigenetic changes can be reversible and can be passed on from one generation to the next. ●Epigenetic changes can lead to cancer and the potential of detecting cancer at an early stage through epigenetic analysis. ●Ideally cancer can be detected before it forms a visible tumor.

Exosomes and Liquid Biopsies ●Exosomes are small, membrane-bound sacs with fluids (vesicles) that are released from cells and carry proteins, lipids, nucleic acids, and metabolites.