Unveiling Cancer’s Hidden Secrets in Your Blood (Hint: It Is Not in Red Blood Cells)

Last updated: 10 April 2025

• Epigenetics Revolution: Research has moved beyond studying only the DNA code to exploring how epigenetics controls gene activity and cancer progression.
• Breakthrough Discovery: Recent studies reveal that 3D chromosome conformations specific to prostate cancer are transferred between cells via exosomes, without direct contact.
• EpiSwitch® PSE Test: Oxford BioDynamics' blood test uses these epigenetic markers to achieve high accuracy detection of prostate cancer.

Significant progress has been made in the fight against cancer, leading to more effective targeted treatments and longer survival rates than ever before. For many years, there was a hope—and even an expectation—that studying and understanding genes and DNA alone would answer all our questions about cancer. However, despite the substantial effort and funding devoted to this approach, many questions about how cancers progress and evade increasingly complex treatments have remained unanswered during this molecular oncology revolution.

Undeterred, researchers began to look beyond genes for clues about how cancer develops, progresses, and spreads to distant organs. Through rigorous clinical research involving molecular diagnostics and targeting disease drivers, they started exploring untapped mechanisms in a field called epigenetics.

Epigenetics studies how genes are turned on or off without altering the underlying DNA sequence. Typically, each cell in the human body contains about two meters of DNA, divided into 23 pairs of chromosomes, which must be tightly folded.

A key aspect of epigenetics is how these chromosomes are condensed and how their three-dimensional (3D) packaging regulates which parts of the DNA are turned on or off. The resultant loops within each chromosome allow distant genes to interact without changing the sequence and have been shown to play significant roles in both normal and abnormal gene expression and cancer progression. It is now possible to determine whether specific loops or conformations within the chromosomes are structurally normal or configured in a way that causes dysfunction. If abnormal, these configurations can provide a tell-tale fingerprint for the presence of and even the clinical characteristics of specific cancers.

In a peer-reviewed medical journal article published in 2022, Oxford BioDynamics reported a groundbreaking discovery.

They found that 3D chromosome conformations specific to prostate cancer cells can be transferred horizontally to an unrelated cell type without direct contact. These unprecedented results were achieved by growing human prostate cancer cells next to human immune cells in a special chamber containing a membrane that kept them completely physically separated. Remarkably, ordinary white blood cells, upon exposure, took on a chromosome conformation—essentially a fingerprint—specific to prostate cancer cells.

The proposed mechanism behind this phenomenon is both fascinating and significant. At its core are exosomes—vesicles outside the cell that enable long-distance communication between cells by transporting molecules such as DNA, RNA, proteins, and lipids. In this way, exosome-based horizontal transfer of epigenetic information from one cell to another distant cell can reset the 3D chromosomal conformation of the recipient cell.

In the 2022 paper mentioned above, exosomes from human prostate cancer cells carried characteristic 3D chromosomal architecture to the immune cells, altering the immune cell's chromosome structure. This discovery is significant because it offers valuable insights for cancer detection and therapeutic decision-making in clinical settings. The mechanism by which cancer cells directly transfer their distinctive 3D architecture to cells circulating in the bloodstream presents a promising source of biomarkers. These biomarkers can be easily accessed for diagnostic or prognostic tests.

In September 2023, Oxford BioDynamics introduced a rapid diagnostic blood test called EpiSwitch® PSE. This innovative cancer screening test leverages the interaction between cancer cells and immune cells in the bloodstream to detect characteristic changes in the 3D chromosome conformation of these circulating cells.

The EpiSwitch PSE is a validated, rapid, highly accurate blood test for prostate cancer (accuracy 94%, specificity 97%, sensitivity 86%)¹, significantly boosting the accuracy of PSA alone. Crucially, the positive predictive value (PPV) of PSE is 93%, compared to just 25% for PSA. PSA's low PPV is one of the main arguments against using it as a population-wide screening test. Only about one-quarter of men with a raised PSA will go on to be diagnosed with prostate cancer.

With the PSE, greater than 9 out of every 10 men who receive a positive "high likelihood" PSE will go onto have a confirmatory biopsy¹. This level of performance can reduce the number of men who do not have prostate cancer being referred for unnecessary MRI scans and invasive biopsies³. These clinical results are supported by an accumulation of real-world evidence related to the clinical utility.

With our advancements in understanding cancer through 3D chromosome conformation and the breakthrough EpiSwitch PSE diagnostic blood test, we are instilling greater hope and confidence in our mission to detect cancers earlier and prolong patients' lives.

References

1) Pchejetski et al., Cancers (2023) https://www.mdpi.com/2072-6694/15/3/821

2) Alshaker et al., Frontiers in Oncology (2022) https://pubmed.ncbi.nlm.nih.gov/36059613/

3) Prostate Cancer Research, Landmark Report into Prostate Cancer Screening (2024) https://www.prostate-cancer-research.org.uk/PFYP/