Novel blood-based early cancer detection: diagnostics in development

Beer, Tomasz M.

doi:10.37765/ajmc.2020.88533

Cited by 21 publications

(18 citation statements)

References 30 publications

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“…A liquid biopsy-based screening paradigm focused on high-risk populations, such as dogs from predisposed breeds or from geriatric populations, could help identify many of these cancers earlier. Early detection has been shown to drive better clinical outcomes in humans, such as increased life expectancy and higher rates of achieving complete remission following curative-intent interventions (e.g., surgery); historically, this has provided the rationale for well-established screening programs such as colonoscopy, mammograms, Pap smears, PSA screening, and low-dose CT scans (183,(215)(216)(217). Liquid biopsy solutions for universal cancer screening in humans are nearing commercialization (216,(218)(219)(220), and some of these assays have also shown potential for predicting the organ of origin of the tumor, facilitating the path to a definitive diagnosis (27, 28, [221][222][223].…”

Section: Screeningmentioning

confidence: 99%

“…In addition to improving outcomes, earlier diagnosis can mitigate the financial burden of treatment, making it a cost-effective paradigm both at the population level and at the level of individual patients. Health economic studies have shown that treatment costs for human cancer patients diagnosed early in the disease course to be 2 to 4 times less than for those diagnosed at later stages (216,217). Treatment for early-stage cancer typically consists of localized resection, which is often curative and has a short recovery time (28); whereas treatment for late-stage disease involves repeat courses of chemotherapy or radiation therapy aimed at extending life rather than achieving a cure.…”

Section: Aid In Diagnosismentioning

confidence: 99%

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Horizons in Veterinary Precision Oncology: Fundamentals of Cancer Genomics and Applications of Liquid Biopsy for the Detection, Characterization, and Management of Cancer in Dogs

Chibuk¹,

Flory²,

Kruglyak³

et al. 2021

Front. Vet. Sci.

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Cancer is the leading cause of death in dogs, in part because many cases are identified at an advanced stage when clinical signs have developed, and prognosis is poor. Increased understanding of cancer as a disease of the genome has led to the introduction of liquid biopsy testing, allowing for detection of genomic alterations in cell-free DNA fragments in blood to facilitate earlier detection, characterization, and management of cancer through non-invasive means. Recent discoveries in the areas of genomics and oncology have provided a deeper understanding of the molecular origins and evolution of cancer, and of the “one health” similarities between humans and dogs that underlie the field of comparative oncology. These discoveries, combined with technological advances in DNA profiling, are shifting the paradigm for cancer diagnosis toward earlier detection with the goal of improving outcomes. Liquid biopsy testing has already revolutionized the way cancer is managed in human medicine – and it is poised to make a similar impact in veterinary medicine. Multiple clinical use cases for liquid biopsy are emerging, including screening, aid in diagnosis, targeted treatment selection, treatment response monitoring, minimal residual disease detection, and recurrence monitoring. This review article highlights key scientific advances in genomics and their relevance for veterinary oncology, with the goal of providing a foundational introduction to this important topic for veterinarians. As these technologies migrate from human medicine into veterinary medicine, improved awareness and understanding will facilitate their rapid adoption, for the benefit of veterinary patients.

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Section: Screeningmentioning

confidence: 99%

Section: Aid In Diagnosismentioning

confidence: 99%

Horizons in Veterinary Precision Oncology: Fundamentals of Cancer Genomics and Applications of Liquid Biopsy for the Detection, Characterization, and Management of Cancer in Dogs

Chibuk¹,

Flory²,

Kruglyak³

et al. 2021

Front. Vet. Sci.

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“…In particular, the possibility of multi-cancer early detection, where a single blood sample is interrogated for multiple cancers, is attracting a great deal of attention. 1,2 Several multi-cancer tests are in development, each harnessing different features of the circulating tumor DNA. Liu et al present a test using targeted methylation analysis of circulating cell-free DNA that in principle detects and localizes more than 50 cancer types, and quantify its sensitivity for a pre-specified set of 12 cancers.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the possibility of multi-cancer early detection, where a single blood sample is interrogated for multiple cancers, is attracting a great deal of attention. 1,2…”

mentioning

confidence: 99%

“…At this point however, many questions exist about the likely impact of multi-cancer testing on population outcome including benefits, such as cancer deaths prevented, and harms, such as unnecessary imaging tests or biopsies. 1 These outcomes depend critically on disease prevalence at the time of the test and mortality in the absence of the test in addition to test performance, particularly its ability to detect and treat potentially fatal disease early.…”

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confidence: 99%

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A Quantitative Framework to Study Potential Benefits and Harms of Multi-cancer Early Detection Testing

Jiao

Gulati

Katki

et al. 2021

Preprint

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Multi–cancer tests permit identification of multiple cancers with one blood draw. The objective of this study was to quantify potential population impact of a multi–cancer test. We formulate mathematical expressions for expected numbers of (1) individuals exposed to unnecessary confirmation tests (UCT), (2) cancers detected (CD), and (3) lives saved (LS) given disease prevalence and mortality and test performance and expected mortality reduction. We consider additions of colorectal, liver, lung, ovary, and pancreatic cancer to a test for breast cancer using published performance characteristics of a multi–cancer test and prevalence of each cancer at ages 50, 60, or 70 based on 5–year incidence rates and corresponding 15–year probabilities of cancer death in the Surveillance, Epidemiology, and End Results registry, assuming 20% mortality reduction for each. We find that UCT depends on screening age but is overwhelmingly determined by overall specificity of the test and is relatively insensitive to the types and number of cancers included. For a given overall specificity, UCT/CD is most favorable for higher prevalence cancers (e.g., UCT/CD=5.6 for breast and lung versus 6.5 for breast and liver at age 50). Under a common mortality reduction, UCT/LS is most favorable when the test includes higher-mortality cancers (e.g., UCT/LS=48.5 for breast and lung versus 74.7 for breast and liver at age 50). In conclusion, the harm-benefit tradeoffs of multi–cancer testing depend on the number and type of cancers included. Overall specificity is paramount for controlling unnecessary confirmation tests. For a given overall specificity, multi–cancer tests should prioritize prevalent and/or lethal cancers for which curative treatments exist.

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The modeling of multicancer early detection (MCED) tests’ residual risk and the challenges of MCED evaluation and implementation

Kessler

Beau

Smith

et al. 2023

Cancer

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Multicancer early detection (MCED) tests represent a potentially game‐changing early cancer detection technology. Modeling efforts, such as those of Hudnut et al. in this issue of Cancer, as well as systematic clinical studies and data collection, along with public health and primary care efforts, need to be undertaken to determine whether MCED tests become an opportunity to decrease the heavy burden of cancer for all.

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Novel blood-based early cancer detection: diagnostics in development

Cited by 21 publications

References 30 publications

Horizons in Veterinary Precision Oncology: Fundamentals of Cancer Genomics and Applications of Liquid Biopsy for the Detection, Characterization, and Management of Cancer in Dogs

Horizons in Veterinary Precision Oncology: Fundamentals of Cancer Genomics and Applications of Liquid Biopsy for the Detection, Characterization, and Management of Cancer in Dogs

A Quantitative Framework to Study Potential Benefits and Harms of Multi-cancer Early Detection Testing

The modeling of multicancer early detection (MCED) tests’ residual risk and the challenges of MCED evaluation and implementation

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