Multi-cancer blood test shows efficacy for early cancer detection

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September 13, 2022

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Schrag D, et al. Abstract 9030. Presented at: Congress of the European Society for Medical Oncology; September 9-13, 2022; Paris.

Disclosures:
GRAIL funded the study. Schrag reports an unpaid consultant role with GRAIL and GRAIL research funding to Dana-Farber to support conducting the trial, as well as a speaking fee from Pfizer and an editor role with JAMA. She consults the summary of the relevant financial disclosures of all the investigators.


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A novel blood test for early detection of various types of cancer identified a common signal for more than 50 types of cancer and predicted where in the body the signal originated among people with undiagnosed cancer.

The findings, presented at the ESMO Congress, also showed the multicancer early detection test (MCED, GRAIL) had an excellent specificity rate for those without cancer, the researchers noted.

Performance of the multicancer early detection test

Data derived from Schrag D, et al. Abstract 9030. Presented at: Congress of the European Society for Medical Oncology; September 9-13, 2022; Paris.

“This study shows that it is indeed possible to detect cancers early with blood tests,” Deb Schrag, MD, MPH, chairman of the department of medicine at Memorial Sloan Kettering Cancer Center, during the presentation.

Methodology

The prospective PATHFINDER study included 6,621 participants aged 50 years and older (median age, 63.4 years; 63% women; 92% white) with or without additional cancer risk factors.

The researchers sought to evaluate a new blood-based MCED test that uses cell-free DNA and machine learning to detect a common cancer signal for more than 50 cancer types, as well as predict the origin of the cancer signal. They collected blood samples, analyzed cell-free DNA, and confirmed the cancer status at one year for all study participants.

The extent of diagnostic testing required for resolution after the MCED test detected a sign of cancer served as the primary outcome. performance test and safety served as secondary outcomes.

Key results

The researchers reported that the test detected a sign of cancer in 1.4% of people who did not previously have cancer, and 38% of people with a positive test result had a confirmed cancer diagnosis. Additionally, 99.1% of people without cancer received a negative test result.

It took a median of 79 days to achieve resolution of diagnosis among those with a positive test result, and resolution of diagnosis was achieved within 3 months among 73% of people.

The test identified a certain predicted origin of the cancer in all but one of the 35 participants with a true-positive result, and in 33 of these (97.1%) it correctly identified the type of tumor origin. Of note, 26 of the cancers diagnosed after a true-positive result lacked standard screening tests.

Deborah Schrag, MD, MPH

deb schrag

“The results are an important first step for early cancer detection tests because they showed a good detection rate for people who did have cancer and an excellent specificity rate for those who did not have cancer,” Schrag said in a news release. . “In people with a positive test, it took less than 2 months to confirm the diagnosis if they had cancer and it took a little longer if they did not have cancer, mainly because doctors chose to perform imaging tests and then repeat them a second time. several months later to investigate the possibility of a cancer diagnosis.”

Schrag said that few of those who received a false-positive result needed to undergo multiple invasive procedures, such as biopsies and endoscopies. “This finding should help allay concerns that these tests could cause harm by creating unnecessary procedures in people who are well,” he said.

Looking to the future

Additional research is currently underway, including a clinical trial of 140,000 asymptomatic people in England to assess the clinical effectiveness of MCED tests on cancer outcomes, Schrag said in the release.

“[The current] The study indicates that there is hope on the horizon for detecting cancers that are currently undetectable, but much more work is of course needed, and with experience and larger samples, these trials will improve,” he said. “The tests need to be refined so that they better distinguish tumor DNA from all other DNA circulating in the blood. It is also critical to keep in mind that the purpose of cancer screening is not to decrease cancer incidence, but rather to decrease cancer mortality. It is premature to draw conclusions about how MCED testing affects mortality, which was not measured in the PATHFINDER study and requires long-term follow-up.”

References:

  • A new era of early cancer detection with blood tests may change cancer detection paradigms (press release). Available in: www.eurekalert.org/news-releases/963772#. Published September 11, 2022. Retrieved September 13, 2022.
  • Schrag D, et al. Abstract 9030. Presented at: Congress of the European Society for Medical Oncology; September 9-13, 2022; Paris.

#Multicancer #blood #test #shows #efficacy #early #cancer #detection

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