“DOSI” – The Medical Device that Aims to Assess Chemotherapy’s Effectiveness in Real Time

One of the more frustrating aspects of treating cancer is the inherent uncertainty in determining which standard cocktail of chemotherapeutic agents will work best for an individual’s unique tumor. Physicians decide which drugs to prescribe by using rubrics that consider the tumor’s genetic composition, tissue structure and size, but it is far from an exact science.

Approximately one in eight women (twelve percent) will develop invasive breast cancer at some point in her life. Breast cancer is typically diagnosed after an abnormal mammogram and a biopsy. A treatment plan is then devised based on the previously mentioned factors. Oftentimes a larger tumor will be treated with chemotherapy in an effort to shrink it prior to surgery. This can be very successful and (for some women) means the difference between a lumpectomy and a mastectomy. Generally speaking, one or two courses of chemo are given before the tumor’s size is reassessed with a mammogram or ultrasound. This intervening period can last weeks or months, significantly delaying any useful knowledge regarding the effectiveness of the cocktail that the patient is being given.

While this is the standard treatment, there are problems with this protocol. Chief among these is the mystery about how the tumor is responding to the drugs during the time between diagnosis and follow-up imaging. In fact, eighteen to twenty-five percent of women don’t respond at all to chemotherapy, but this is generally not discovered until well into the treatment plan. If the treatment is ineffective, the tumor may even have grown. Another unfortunate consequence of this method is the real possibility of enduring the unpleasant side effects of chemo without experiencing any benefits.

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The scientific/medical community constantly develops devices in hopes of improving life for cancer patients. Some of them end up as useful tools in the fight against the disease and many end up falling to the wayside, but advancements are made constantly, and the research is exciting.

Darren Roblyer PhD. and his team at Boston University are hoping to help physicians shorten the time it takes to determine if chemotherapy is working. They are developing a device called Diffuse Optical Spectroscopic Imaging (DOSI), which utilizes “near” infrared light to analyze the effectiveness of a drug almost instantaneously. Used as early as the first chemo session, DOSI’s light penetrates through the skin and into the tumor to gauge the metabolic activity occurring inside of it – as the medicines are being administered. The images generated by DOSI reveal useful information about oxygenated blood flow and fluid build-up in real time. Ultimately, the goal is to provide data that allows physicians to witness the malignancy’s response to drug during the initial infusion session.

Gaining an understanding of the unique biology of an individual’s tumor would ideally be used to create a personalized treatment that leads to a better outcome for the patient. Waiting periods between treatments could possibly be shortened and the distasteful side effects of chemo might be delayed until the most effective drug is found. A wearable version of the device is being developed as well. This would enable doctors to continuously monitor the tumor’s response to the drug.

Cancer patients are desperate to know if a treatment is working, and the sooner they can find out, the better. Though still in the development phase, the DOSI device may eventually prove to be a useful tool when it comes to determining which chemotherapy has the best chance to help a particular patient. Every tumor is one-of-a-kind, so the possibility of analyzing each one’s unique characteristics and creating a specific plan of attack would be an incredible addition to the arsenal of cancer treatments.