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Medical Rounds

At the Bench: New Screen for Eight Cancer Types

Johns Hopkins Kimmel Cancer Center researchers have developed a single blood test that screens for eight common cancer types and helps identify the location of the cancer.

The test, called CancerSEEK, is a unique noninvasive, multianalyte test that simultaneously evaluates levels of eight cancer proteins and the presence of cancer gene mutations from circulating DNA in the blood. The test is aimed at screening for cancers of the ovary, liver, stomach, pancreas, esophagus, colorectum, lung or breast which together account for more than 60 percent of cancer deaths in the United States. Five of the cancers covered by the test (ovarian, liver, stomach, pancreatic and esophageal) currently have no screening test.

The researchers point out that CancerSEEK is solely aimed at cancer screening and, therefore, is different from other molecular tests, which rely on analyzing large numbers of cancer-driving genes to identify therapeutically actionable targets.

“The use of a combination of selected biomarkers for early detection has the potential to change the way we screen for cancer, and it is based on the same rationale for using combinations of drugs to treat cancers,” says Nickolas Papadopoulos, professor of oncology and pathology and senior author of the paper published online in Science in January.

“Circulating tumor DNA mutations can be highly specific markers for cancer. To capitalize on this inherent specificity, we sought to develop a small yet robust panel that could detect at least one mutation in the vast majority of cancers,” says Joshua Cohen, an M.D.-Ph.D. student at the school of medicine and the paper’s first author. “In fact, keeping the mutation panel small is essential to minimize false-positive results and keep such screening tests affordable.”

In this study, the test had greater than 99 percent specificity for cancer. “Very high specificity was essential because false-positive results can subject patients to unnecessary invasive follow-up tests and procedures to confirm the presence of cancer,” says Kenneth Kinzler, co-director of the Ludwig Center.

CancerSEEK is noninvasive and can, in principle, be administered by primary care providers at the time of other routine blood work. “This test represents the next step in changing the focus of cancer research from late-stage disease to early disease, which I believe will be critical to reducing cancer deaths in the long term,” says Bert Vogelstein, co-director of the Ludwig Center.

The investigators feel that a test that will be used routinely for cancer screening must have a cost in line with or less than other currently available screening tests for single cancers, such as colonoscopy. They envision that the CancerSEEK test will eventually cost less than $500. Larger studies of the test are currently under way.