Early detection of cancer by blood test may change cancer screening

Prepare for big changes early cancer Detection affecting almost all stages of cancer diagnosis and treatment. cancer Physicians, healthcare providers, and payers must do this. According to ESMO 2022 Scientific Co-Chair Fabrice Andre, new data presented at his ESMO Congress in 2022 showing the reliability of the multiple cancer early detection (MCED) blood test (1) will improve the delivery of cancer treatments. It will have a big impact on how you do it. future.

“Professional bodies such as ESMO are well aware of the fact that within the next five years, we will need to increase the number of doctors, surgeons and nurses, as well as the diagnostic and therapeutic infrastructure, to care for an increasing number of patients. We have a duty to raise awareness, which will be identified by early detection tests for multiple cancers,” said the newly elected 2025-2026 Director of Research at the Gustave Roussy Cancer Center in Villejuif, France. Andre, the future association president, explained. “We need to involve all stakeholders in determining new pathways of care. Agree on who, when and where to be tested, and anticipate changes that will result from these tests. For example, in the diagnosis and treatment of patients with pancreatic cancer and other cancers that are usually diagnosed at a much later stage.”

More than 50 different types of cancer each have a common cancer signal, and a new MCED test in development can pinpoint and pinpoint where in the body the signal originated. This signature is produced by short segments of tumor DNA (ctDNA) circulating in the blood. It differs from non-tumor DNA with respect to its methylation pattern.

In the PATHFINDER study, presented at the 2022 ESMO Congress, the MCED test identified cancer signals in 1.4% of 6,621 adults aged 50 and over who had not previously been diagnosed with cancer. Cancer was confirmed in her 38% of those who tested positive. His 99.1% of 6290 cancer-free individuals had negative test results. If the test was positive, it took him a median of 79 days before the diagnosis was made (i.e. no evidence of cancer was found or malignancy requiring further study). ). 73% of participants with a positive screening test resolved their diagnostic problem within 3 months.

The results show that the detection rate is high in people with cancer and the specificity is high in people without cancer, an important first step in early cancer detection tests. “It took less than two months to establish a diagnosis of cancer in patients who tested positive, but in others it took longer. Because we chose to perform the test and then repeat it a second time, several months later, to investigate the possibility of diagnosing cancer,” said senior author of the study, Memorial in New York, USA. said Deb Schrag of Sloan Kettering Cancer Center.

The fact that few participants had false-positive screening tests and required invasive procedures such as endoscopy or biopsy was an important finding. This finding should allay concerns that these diagnoses can harm healthy individuals by requiring unnecessary treatment.

Although the MCED test is currently being developed and validated for malignancies such as pancreatic, small bowel, and gastric cancers for which there are no screening alternatives, she is a regular candidate for tumors such as breast and colorectal cancer. He stressed the need for continued screening.

“This study suggests that it may detect tumors that are currently undetectable, but clearly more effort is needed and these tests will get better with practice and larger samples. According to Schrag, the test needs to improve in order to better identify tumor DNA from all other DNA circulating in the blood. It is also important to remember that the PATHFINDER trial is intended to reduce mortality. It is too early to draw any conclusions about how

Previous studies have only included testing in individuals known to already have cancer, so the study presented at the 2022 ESMO conference will focus on patients with undiscovered disease. This is the first prospective analysis demonstrating that the MCED test can detect cancers in Many more studies are now being conducted, including in the UK he enrolled 140,000 asymptomatic individuals in a pivotal randomized trial to examine the therapeutic utility of his MCED test on cancer outcomes. clinical trials are included (2).

If early detection tests impact morbidity and mortality, comparative studies across all cancer types are needed. In addition, he said, he needs to understand how results are communicated to patients and how the test can help them. We also need to learn more about the small percentage of false-positive test or MCED results that suggest the presence of cancer but are not validated by conventional diagnostic techniques. Some of these answers are needed before he can estimate the economic impact of including MCED testing in standard clinical practice, Andre said.

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