The following article features coverage from the American Association for Cancer Research (AACR) 2020 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

A multicancer plasma blood test detected cancer among older women without a history of cancer, particularly when combined with standard-of-care screening, according to results of an interim analysis presented at the American Association for Cancer Research (AACR) Virtual Annual Meeting I 2020.1

The study was simultaneously published in Science.2

“This is the first study to show that it [a blood test] can be used to guide patient management in real time,” Nickolas Papadopoulos, PhD, of Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore, Maryland, and author of the study, said.

The prospective, interventional DETECT-A study evaluated the DETECT-A blood test in a cohort of 9911 women aged 65 to 75 years without current or previous known cancer.1,2 This age group “allows for rigorous evaluation of cancer despite the presence of a variety of other conditions,” Dr Papadopoulos said.


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All patients were enrolled through the Geisinger Health System, which enabled access to electronic medical records and minimized loss to follow-up.1 All patients underwent the DETECT-A blood test. Patients who tested were positive underwent a second blood test to determine if the same biomarker was abnormal and were then screened by a full-body PET-CT with fluorodeoxyglucose (FDG) contrast to identify the putative cancer.1,2

The DETECT-A blood test is an earlier version of the CancerSEEK test, and was the test that was available when this study was initiated in 2016 to 2017.1 The CancerSEEK test includes improvements in test characteristics. The DETECT-A test is a multianalyte test that uses both DNA and protein biomarkers, covering 1933 bases of 16 commonly mutated genes and 9 proteins with known associations with cancer.

The DETECT-A test was positive in 4.9% of patients in the baseline test, and 1.35% of patients were subsequently confirmed to have the same abnormal biomarker, confirming the initial blood test.2 Of patients whose test was not confirmed, 60% of the positive tests were due to clonal hematopoiesis of indeterminate potential (CHIP).

Of the 134 patients with a confirmed positive test, 95% were evaluated by PET-CT, and 50% of these patients (64 individuals) had results suspicious for cancer.2 Biopsy confirmed cancer in 41% of these cases (26 individuals).

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DETECT-A had a positive predictive value of 19%, which increased to 41% when combined with imaging.1 Of the cancers detected, 65% were localized or regional. DNA mutations resulted in detection in 57% of cases and the remaining were detected through protein.

Use of the DETECT-A test did not discourage standard-of-care cancer screening, as determined by a patient-completed survey conducted among study participants.1

Dr Papadopoulos said that these results indicated that “it is feasible for a minimally invasive blood test to safety detect several types of cancers in patients not previously known to have cancer.” He added that this could enable treatment with intent to cure in some patients.

Read more of Cancer Therapy Advisor‘s coverage of AACR 2020 meeting by visiting the conference page.

Reference

  1. Papadopoulos N. A first-of-its-kind prospective study of a multi-cancer blood test to screen and manage 10,000 women with no history of cancer. Presented at: American Association for Cancer Research (AACR) Virtual Annual Meeting I; April 28, 2020. Abstract CT022.
  2. Lennon AM, Buchanan AH, Kinde I, et al. Feasibility of blood testing combined with PET-CT imaging to screen for cancer and guide intervention [published online April 28, 2020]. Science. doi: 10.1126/science.abb9601