Clinical OMICS

MAR-APR 2018

Healthcare magazine for research scientists, labs, pathologists, hospitals, cancer centers, physicians and biopharma companies providing news articles, expert interviews and videos about molecular diagnostics in precision medicine

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Diagnostics 16 Clinical OMICs March/April 2018 www.clinicalomics.com Standing Sentinel A Multi-Analyte Test Marks a New Milestone in Early Cancer Detection By Meghaan Ferreira, Ph.D. V ictory often depends on good counterintelligence— and the war on cancer is no exception. Scientists have proven the value of circulating tumor DNA (ctDNA) and cir- culating tumor cells as informants, and the number of pub- lications starring these double agents has rocketed skyward over the past several years. While "liquid biopsies" have the potential to improve clinical care for late-stage disease by providing clinicians with information on patient progno- sis, treatment efficacy, and disease recurrence, research has also demonstrated their ability to alert clinicians to tumors before standard screening methods—allowing earlier inter- vention and, ultimately, saving lives. Several companies—including Grail, Illumina's bil- lion-dollar spin-off—have entered an arms race for earlier detection of these sentinels, and now a team of researchers at Johns Hopkins Kimmel Cancer Center has made significant strides in the search for oncology's so-called holy grail. Described in a recent Science article, entitled "Detection and localization of surgi- cally resectable cancers with a multi-analyte blood test ," the team's blood-based diagnos- tic, CancerSEEK, marks a new milestone for early-stage cancer detection. On average, the test detected 70% of cases in a 1,005-patient cohort diagnosed with eight common forms of non-metastatic tumors including breast, colorectal, esoph- ageal, liver, lung, ovarian, pancreatic, and stomach. The test's sensitivity ranged from 33% in breast cancer to 98% in ovarian can- cer. Together, these eight cancers account for an estimated 360,000, or 60%, of cancer deaths annually in United States, and no screening methods currently exist for five of these. While physiological limitations make it extremely dif- ficult to detect the minuscule amount of ctDNA amongst normal cell-free DNA—analogous to finding a needle in a haystack—with high enough sensitivity and specificity for early-stage cancer screening, CancerSEEK overcomes these limitations by combining a panel of 16 genes, known to har- bor cancer-driving mutations, with 8 protein biomarkers. In a conversation with Genetic Engineering & Biotechnology News, the paper 's senior author, Nickolas Papadopoulos, Ph.D., professor of oncology and pathology at Johns Hop- kins remarked, "The use of a combination of selected bio- markers for early detection has the potential to change the way we screen for cancer." Successful screening tests need to maximize detection sensitivity, ideally outperforming current methods, while also minimizing both cost and false-positive results. In addition to having an estimated cost of less than $500, Can- CancerSEEK takes a multi-analyte approach to cancer detection.

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