Multi-Cancer Early Detection

Published Jan. 20, 2024

By Hopkins Medtech

What is Multi-Cancer Early Detection?

Multi-cancer Early Detection refers to a comprehensive approach to cancer screening that aims to detect multiple types of cancer simultaneously or within a single test, especially sample drawn from blood. The blood sample is tested for certain pieces of DNA or proteins from cancer cells. If these are found, it might mean that the person has cancer, and it might also show which organ the cancer started in. Some MCED tests only test for the likelihood that there is cancer somewhere in the body, so if a person has a positive test result, they will need other tests, like imaging tests, to try to figure out where in the body the abnormal DNA or proteins came from.

Why are MCED tests being developed?

Currently, there are proven screening tests for some types of cancer (including breast, cervical, colorectal, prostate, and lung), because they’ve led to finding and treating these types of cancer earlier. Cancers that are found early are often easier to treat and tend to have better outcomes.

But most cancers do not have proven early detection screening tests. In fact, about 70% of all cancer deaths come from cancers for which there are currently no proven screening tests. These cancers are often diagnosed at an advanced stage when they can be harder to treat.

Currently, there are around 20 tests in development. They offer screening for anywhere from two to over 50 tumor types in a single test. Some of the cancers the tests can detect include pancreatic, prostate, kidney, lung, breast, skin, ovarian and liver cancer.

MCED tests might be able to find a wide range of cancers earlier, hopefully before a person has any symptoms.

What are the risks of using multi-cancer early detection tests?

Eager to rule out a cancer diagnosis, patients may focus on the potential benefits of multi-cancer early detection tests while overlooking the risks and limitations. Multi-cancer tests may generate false-positive results, indicating the presence of cancer when none exists. This can lead to unnecessary anxiety, further invasive testing, and potentially unnecessary treatments or interventions.

Detecting slow-growing or indolent cancers that may never cause harm or lead to symptoms during a person’s lifetime can result in overdiagnosis. This may lead to unnecessary treatments that pose risks without providing clear benefits.

There are concerns that early-stage tumors won’t provide much DNA. This means the tumors may have to be further along to generate enough DNA to be reliably detected by the blood test. Multi-cancer tests might have limitations in their sensitivity and specificity, potentially missing certain types or stages of cancer or identifying non-cancerous conditions as cancerous.

Most common approaches and technologies of multi-cancer early detection

Blood-Based Biomarkers:

Circulating Tumor DNA (ctDNA): Analyzing fragments of tumor DNA released into the bloodstream to detect mutations or alterations associated with various cancers.

Proteomics:

Identifying specific proteins or biomarkers present in blood that indicate the presence of certain cancers.

Multi-Analyte Assays:

Developing assays that combine the analysis of multiple biomarkers, such as proteins, nucleic acids, or other molecular markers, to enhance the sensitivity and specificity of cancer detection.

Artificial Intelligence (AI) and Machine Learning:

Using AI algorithms to analyze complex data sets from various sources, including imaging, genomic, and clinical data, to identify patterns indicative of different cancer types.

Imaging Technologies:

Developing advanced imaging technologies, such as positron emission tomography (PET), magnetic resonance imaging (MRI), or optical imaging, to detect early signs of multiple cancers.

Liquid Biopsies:

Using minimally invasive tests that analyze bodily fluids like blood, urine, or saliva to detect genetic mutations, circulating tumor cells, or other cancer-related biomarkers.

DNA Methylation Analysis:

Assessing DNA methylation patterns associated with cancer-related changes to detect multiple cancers.

Comprehensive Genomic Sequencing:

Whole-genome or whole-exome sequencing approaches that aim to identify genetic alterations across multiple cancer types.

Integrated Panels or Tests:

Some companies are developing integrated panels or tests that combine various technologies and biomarkers to detect multiple types of cancer within a single assay.