Journal Article

Detection and localization of surgically resectable cancers with a multi-analyte blood test

Wang, Tian-Li, Brand, Randall E., Allen, Peter J., Dal Molin, Marco, Wong, Hui-Li, Tie, Jeanne, Thoburn, Christopher, Hruban, Ralph H., Falconi, Massimo, Tomasetti, Cristian, Schaefer, Joy, Roden, Richard, Ptak, Janine, Papadopoulos, Nickolas, Popoli, Maria, Zhou, Shibin, Klein, Alison P., Wang, Yuxuan, Javed, Ammar A., Dobbyn, Lisa, Browne, James D., Mattox, Austin, Diaz, Luis A., Schoen, Robert E., Lennon, Anne Marie, Douville, Christopher, Wolfgang, Christopher L., Goggins, Michael G., Silliman, Natalie, Wong, Fay, Gibbs, Peter, Mansfield, Aaron S., Vogelstein, Bert, Afsari, Bahman, Vogelstein, Joshua T., Cohen, Joshua D., Kinzler, Kenneth W., Jen, Jin, Bettegowda, Chetan, Li, Lu, Hanash, Samir M., Danilova, Ludmila

2018

Overview

Many cancers can be cured by surgery and/or systemic therapies when detected before they have metastasized. This clinical reality, coupled with the growing appreciation that cancer's rapid genetic evolution limits its response to drugs, have fueled interest in methodologies for earlier detection of the disease. Cohen et al. developed a noninvasive blood test, called CancerSEEK that can detect eight common human cancer types (see the Perspective by Kalinich and Haber). The test assesses eight circulating protein biomarkers and tumor-specific mutations in circulating DNA. In a study of 1000 patients previously diagnosed with cancer and 850 healthy control individuals, CancerSEEK detected cancer with a sensitivity of 69 to 98% (depending on cancer type) and 99% specificity. Science , this issue p. 926 ; see also p. 866 A blood test that combines protein and DNA markers may allow earlier detection of eight common cancer types. Earlier detection is key to reducing cancer deaths. Here, we describe a blood test that can detect eight common cancer types through assessment of the levels of circulating proteins and mutations in cell-free DNA. We applied this test, called CancerSEEK, to 1005 patients with nonmetastatic, clinically detected cancers of the ovary, liver, stomach, pancreas, esophagus, colorectum, lung, or breast. CancerSEEK tests were positive in a median of 70% of the eight cancer types. The sensitivities ranged from 69 to 98% for the detection of five cancer types (ovary, liver, stomach, pancreas, and esophagus) for which there are no screening tests available for average-risk individuals. The specificity of CancerSEEK was greater than 99%: only 7 of 812 healthy controls scored positive. In addition, CancerSEEK localized the cancer to a small number of anatomic sites in a median of 83% of the patients.

• Publisher: The American Association for the Advancement of Science
• Subject: Biological evolution / Biomarkers / Blood / Blood tests / Breast cancer / Cancer / Circulating Tumor DNA - genetics / Control Groups / Costs and Cost Analysis / Deoxyribonucleic acid / DNA / Early Detection of Cancer - economics / Early Detection of Cancer - methods / Esophagus / Evolution & development / Hematologic Tests - economics / Humans / Liver / Liver cancer / Localization / Lungs / Mutation / Neoplasm Proteins - blood / Neoplasms - blood / Neoplasms - diagnosis / Neoplasms - genetics / Neoplasms - surgery / Ovarian cancer / Pancreas / Patients / Polymerase Chain Reaction - methods / Proteins / Screening Tests / Sensitivity / Stomach / Surgery