Feasibility of blood testing combined with PET-CT to screen for cancer and guide intervention

• Type of Material: Article
• Authors: Anne Marie Lennon, Johns Hopkins University; Adam H. Buchanan, Geisinger; Isaac Kinde, Thrive Earlier Detection Corp.; Andrew Warren, Thrive Earlier Detection Corp.; Ashley Honushefsky, Geisinger; Ariella T. Cohain, Thrive Earlier Detection Corp.; David H. Ledbetter, Geisinger; Alfred Sanfilippo, Emory University; Kathleen Sheridan, Geisinger; Dillenia Rosica, Geisinger; Christian S. Adonizio, Geisinger; Hee Jung Hwang, Thrive Earlier Detection Corp; Kamel Lahouel, Johns Hopkins University; Joshua D. Cohen, Johns Hopkins University; Christopher Douville, Johns Hopkins University; Aalpen A. Patel, Geisinger; Leonardo N. Hagmann, Thrive Earlier Detection Corp.; David D. Rolston, Geisinger; Nirav Malani, Thrive Earlier Detection Corp.; Shibin Zhou, Johns Hopkins University; Chetan Bettegowda, Johns Hopkins University; David L. Diehl, Geisinger; Bobbi Urban, Thrive Earlier Detect Corp; Christopher D. Still, Geisinger; Lisa Kann, Thrive Earlier Detection Corp.; Julie I. Woods, Geisinger; Zachary M. Salvati, Geisinger; Joseph Vadakara, Geisinger; Rosemary Leeming, Geisinger; Prianka Bhattacharya, Geisinger; Carroll Walter, Geisinger; Alex Parker, Thrive Earlier Detection Corp.; Christoph Lengauer, Thrive Earlier Detection Corp.; Alison Klein, Johns Hopkins University; Cristian Tomasetti, Johns Hopkins University; Elliot K. Fishman, Johns Hopkins University; Ralph H. Hruban, Johns Hopkins University; Kenneth W. Kinzler, Johns Hopkins University; Bert Vogelstein, Johns Hopkins University; Nickolas Papadopoulos, Johns Hopkins University
• Language: English
• Date: 2020-07-03
• Publisher: American Association for the Advancement of Science
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 American Association for the Advancement of Science. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1126/science.abb9601
• Title of Journal or Parent Work: Science
• Volume: 369
• Issue: 6499
• Start Page: 49
• End Page: +
• Grant/Funding Information: This work was supported by The Marcus Foundation; Lustgarten Foundation for Pancreatic Cancer Research; The Virginia and D.K. Ludwig Fund for Cancer Research;; The Sol Goldman Center for Pancreatic Cancer Research; Susan Wojcicki and Dennis Troper; the Rolfe Foundation; The Conrad R. Hilton Foundation;; The John Templeton Foundation; Burroughs Wellcome Career Award For Medical Scientists; ancillary support to investigators was provided by National Institutes of Health grants and contracts CA06973, U01-CA152753, U01-CA230691, P50-CA62924, R44CA203350, R37CA230400, T32-GM007309, and HHSN261201600034C.
• Keywords: Multidisciplinary Sciences; Mutations; DNA; Science & Technology - Other Topics; Diagnosis; Strategies; Science & Technology; Plasma; Quantification
• Research Categories: Health Sciences, Pathology; Biology, Biostatistics; Biology, Bioinformatics; Health Sciences, Oncology; Biology, Neuroscience

Abstract

Cancer treatments are often more successful when the disease is detected early. We evaluated the feasibility and safety of multicancer blood testing coupled with positron emission tomography-computed tomography (PET-CT) imaging to detect cancer in a prospective, interventional study of 10,006 women not previously known to have cancer. Positive blood tests were independently confirmed by a diagnostic PET-CT, which also localized the cancer. Twenty-six cancers were detected by blood testing. Of these, 15 underwent PET-CT imaging and nine (60%) were surgically excised. Twenty-four additional cancers were detected by standard-of-care screening and 46 by neither approach. One percent of participants underwent PET-CT imaging based on false-positive blood tests, and 0.22% underwent a futile invasive diagnostic procedure. These data demonstrate that multicancer blood testing combined with PET-CT can be safely incorporated into routine clinical care, in some cases leading to surgery with intent to cure.