Authored by Krystal Ramnarine
What if we could revolutionize the way we detect and treat cancer?
Cancer, a formidable adversary that has challenged medical science for decades, may soon face a new and powerful opponent in the form of Multicancer Early Detection (MCED) technology–a valuable contribution to the growing field of precision medicine.
MCED tests, also referred to as Multi-cancer Detection (MCD) or liquid biopsy tests, measure biological signals that cancer cells may shed in the blood. The assay seeks out biomarkers, or tumor markers, in a patient’s blood to determine molecular evidence of cancer [1]. A vital factor in the successful care for cancer patients is early detection.This innovation could offer extensive advances to this realm as it is poised to transform the way we approach not only cancer screening but diagnosis and treatment as well. MCED represents a paradigm shift in our fight against the disease, offering the promise of upstream progress, more targeted therapies, and ultimately, improved outcomes for patients.
Unlike traditional cancer screening methods that focus on a single type of cancer, MCED tests have the remarkable ability to detect a wide range of types through a simple blood test. This means that a single test could potentially uncover multiple forms of cancer in their earliest stages, when treatment is most effective. Currently, we only have reliable, proven screening tests for breast, cervical, colorectal, prostate, and lung cancer. In fact, about 70% of all cancer deaths are due to the lack of screening tests for a majority of cancer types. [2]. Without screening methods available, these cancers are primarily diagnosed at later stages, which drastically decrease patients’ survival rates.
MCED can identify cancer cells or their biomarkers before they cause symptoms, enabling doctors to intervene earlier with targeted therapies, surgery, or other treatment modalities. This early intervention can make a profound difference in a patient's prognosis and quality of life.
Types of biomarkers include mutations, methylation, fragmentation-based, and non-coding RNA based tests [3].
Various molecular diagnostics companies are working on bringing this test to the market. One promising example is a test called CancerSEEK, which was given breakthrough device designation by the FDA to allow acceleration of trials in 2019. It is currently being developed to detect eight common cancers (lung, breast, colorectal, pancreatic, gastric, hepatic, esophageal, and ovarian) based on the analysis of mutations in 16 genes combined with the circulating levels of eight proteins [3]. The research supporting this test was conducted through a large, prospective interventional study known as DETECT-A, led by researchers from Johns Hopkins and Geisinger. The study demonstrated the blood test's ability to identify cancers in individuals who had no previous cancer history, significantly increasing the number of cancers discovered through screening. With the incorporation of the blood test, the percentage of cancers detected through screening leaped from 25% to 52%. Impressively, it uncovered cancers in 10 different organs, seven of which currently lacked established screening methods. When paired with imaging, the test exhibited remarkable accuracy, reducing the occurrence of false positive results with a specificity of 99.6% [4]
Another significant advantage of MCED technology is its potential to reduce the need for invasive diagnostic procedures such as biopsies. Currently, many cancer diagnoses require tissue samples obtained through surgical procedures, which can be uncomfortable, risky, and costly. Tissue sampling has been the preferred standard for cancer diagnosis, but several disadvantages have risen: “(1) it requires an invasive collection procedure; (2) some tumors are not easily accessible due to their anatomical location; (3) it has limited ability to be used as an early detection tool; (4) it has limitations in the evaluation of treatment efficacy and monitoring of tumor progression; and (5) it does not fully represent tumor heterogeneity” [3]. With MCED testing, a quick procedure could provide ample valuable diagnostic information, sparing patients from the physical and emotional burdens associated with invasive testing.
It is worth noting that MCED technology is relatively new to the healthcare arena and currently lacks FDA approval. Furthermore, the National Cancer Institute (NCI) has not funded any
MCED clinical trials as of now. However, looking ahead, the NCI has revealed plans to launch the Vanguard Study of MCDs in 2024, which will pave the way for future large-scale clinical trials and other research endeavors to evaluate various technologies for cancer screening and their potential impact on reducing cancer-related mortality [5].
MCED technology represents a transformative leap forward in our battle against cancer. Its potential to revolutionize cancer detection, diagnosis, and treatment is nothing short of revolutionary. As research and development continue to advance, we stand on the brink of a new era in healthcare, one where early detection and personalized treatment become the norm, offering hope and healing to countless individuals affected by cancer. While there may still be challenges to overcome, the future of cancer care is undoubtedly brighter with MCED technology leading the way.
Works Cited
1. Questions and answers about MCD tests. Division of Cancer Prevention. (n.d.). https://prevention.cancer.gov/major-programs/multi-cancer-detection-mcd-research/quest ions-and-answers-about-mcd-tests
2. Multi-cancer early detection tests: MCED: Grail Galleri test. Multi-cancer Early Detection Tests | MCED | GRAIL Galleri Test | American Cancer Society. (n.d.). https://www.cancer.org/cancer/screening/multi-cancer-early-detection-tests.html
3. Brito-Rocha, T., Constâncio, V., Henrique, R., & Jerónimo, C. (2023). Shifting the Cancer Screening Paradigm: The Rising Potential of Blood-Based Multi-Cancer Early Detection Tests. Cells, 12(6), 935. https://doi.org/10.3390/cells12060935
4. Liquid biopsies: What you should know. Let’s Win Pancreatic Cancer. (2023, February 1). https://letswinpc.org/research/liquid-biopsies-what-you-should-know/#:~:text=The%20F DA%20has%20designated%20CancerSEEK,due%20to%20its%20lifesaving%20potentia l.
5. Biomarker Testing for Cancer Treatment. National Cancer Institute. (n.d.). https://www.cancer.gov/about-cancer/treatment/types/biomarker-testing-cancer-treatment
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