Buchanan Adam H, Lennon Anne M, Choudhry Omair A, Elias Paul Z, Rego Seema P, Sadler Jennifer R, Roberta Julia, Zhang Yongqiang, Flake Darl D, Salvati Zachary M, Wagner Eric S, Fishman Elliot K, Papadopoulos Nickolas, Beer Tomasz M
Geisinger Health System, Danville, Pennsylvania.
University of Pittsburgh, Pittsburgh, Pennsylvania.
Cancer Prev Res (Phila). 2024 Aug 1;17(8):349-353. doi: 10.1158/1940-6207.CAPR-24-0107.
In the US, <20% of cancers are diagnosed by standard-of-care (SoC) screening. Multicancer early detection (MCED) tests offer the opportunity to expand cancer screening. Understanding the characteristics and clinical outcomes of MCED-detected cancers is critical to clarifying MCED tests' potential impact. DETECT-A is the first prospective interventional trial of an MCED blood test (CancerSEEK). CancerSEEK, coupled with diagnostic PET-CT, identified cancers including those not detected by SoC screening, the majority of which were localized or regional. We report multiyear outcomes in patients with cancers diagnosed following a positive CancerSEEK test. Nine cancer types were diagnosed in 26 participants whose cancers were first detected by CancerSEEK. Information on cancer diagnoses, treatments, and clinical outcomes was extracted from medical records through November 2022. Data collection occurred at a median of 4.4 years (IQR: 4.1-4.6) following study enrollment. Thirteen of 26 (50%) participants were alive and cancer-free [ovarian (4), thyroid (1), uterine (2), breast (1), colorectal (2), and lung (3)]; 7/13 (54%) had cancers without recommended SoC screening modalities. All eight treated stage I or II participants (8/8, 100%) and 12/14 (86%) surgically treated participants were alive and cancer-free. Eligibility for surgical treatment was associated with favorable multiyear outcomes (P = 0.0002). Half of participants with MCED-detected cancers were alive and cancer-free after 4.4 years median follow-up. Most were diagnosed with early-stage cancers and were treated surgically. These results suggest that early cancer detection by CancerSEEK may have facilitated curative-intent treatments and associated positive clinical outcomes in some DETECT-A participants. Prevention Relevance: This study provides preliminary evidence of the potential of multicancer early detection testing as an effective screening tool for detecting cancers without standard-of-care (SoC) screening modalities and complementing SoC cancer screening.
在美国，不到20%的癌症是通过标准治疗（SoC）筛查诊断出来的。多癌早期检测（MCED）测试为扩大癌症筛查提供了机会。了解MCED检测出的癌症的特征和临床结果对于阐明MCED测试的潜在影响至关重要。DETECT-A是第一项关于MCED血液检测（CancerSEEK）的前瞻性干预试验。CancerSEEK结合诊断性PET-CT，识别出了包括那些未被SoC筛查检测到的癌症，其中大多数为局限性或区域性癌症。我们报告了CancerSEEK检测呈阳性后被诊断出患有癌症的患者的多年结果。26名参与者被诊断出患有9种癌症类型，他们的癌症最初是由CancerSEEK检测到的。通过查阅医疗记录，收集了截至2022年11月的癌症诊断、治疗和临床结果信息。数据收集发生在研究入组后的中位时间4.4年（IQR：4.1 - 4.6）。26名参与者中有13名（50%）存活且无癌[卵巢癌（4例）、甲状腺癌（1例）、子宫癌（2例）、乳腺癌（1例）、结直肠癌（2例）和肺癌（3例）]；13名中有7名（54%）患有未推荐进行SoC筛查方式的癌症。所有8名接受治疗的I期或II期参与者（8/8，100%）和14名接受手术治疗的参与者中有12名（86%）存活且无癌。手术治疗的适宜性与良好的多年结果相关（P = 0.0002）。中位随访4.4年后，一半的MCED检测出癌症的参与者存活且无癌。大多数被诊断为早期癌症并接受了手术治疗。这些结果表明，CancerSEEK早期癌症检测可能在一些DETECT-A参与者中促进了根治性治疗及相关的积极临床结果。预防相关性：本研究提供了初步证据，证明多癌早期检测测试作为一种有效的筛查工具，对于检测未采用标准治疗（SoC）筛查方式的癌症以及补充SoC癌症筛查具有潜力。
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