Post Carl, Braun Theodore P, Etzioni Ruth, Nabavizadeh Nima
Department of Radiation Medicine, Oregon Health & Science University, Portland, OR.
Division of Hematology & Medical Oncology, Oregon Health & Science University, Portland, OR.
JCO Oncol Pract. 2023 Dec;19(12):1111-1115. doi: 10.1200/OP.23.00260. Epub 2023 Oct 18.
A multitude of blood-based multicancer early detection (MCED) tests assessing cancer-related alterations in circulating genomic analytes and other associated signatures are currently being developed with the potential to disrupt current single-organ screening paradigms. Pathways for clinical implementation of these novel MCED tests have not been delineated, particularly for the patients with signal positive results requiring additional confirmatory testing. In this overview, we highlight early results from prospective clinical studies testing the efficacy of genomic MCED tests in cohorts of patients without known cancer diagnoses. Additionally, we discuss a proposed professional expansion of the oncology practice relating to the diagnostic workup of individuals found to have an MCED signal positive for cancer. As MCED blood tests have the potential to dramatically upend current cancer screening paradigms and downstream cancer therapy, it is imperative for oncologists to be aware of important clinical studies and the multitude of unanswered questions. The current gaps in the clinical implication of these tests may serve as a meaningful and rewarding expansion of oncology practice.
目前正在开发大量基于血液的多癌早期检测（MCED）测试，这些测试用于评估循环基因组分析物和其他相关特征中与癌症相关的改变，有可能打破当前单一器官筛查模式。这些新型MCED测试的临床实施途径尚未明确，特别是对于那些检测结果呈阳性信号且需要进一步确诊测试的患者。在本综述中，我们重点介绍了前瞻性临床研究的早期结果，这些研究测试了基因组MCED测试在无已知癌症诊断的患者队列中的有效性。此外，我们还讨论了肿瘤学实践中与被发现MCED癌症信号呈阳性的个体诊断检查相关的拟议专业扩展。由于MCED血液检测有可能彻底颠覆当前的癌症筛查模式和下游癌症治疗，肿瘤学家必须了解重要的临床研究以及众多未解决的问题。这些检测在临床意义上的当前差距可能成为肿瘤学实践中有意义且有价值的扩展。
