tests can be recommended for cancer screening in the general population (319). Ongoing efforts are focused on developing strategies to ensure that liquid biopsy tests are specific in detecting cancer(s) without compromising sensitivity of the test (320). An exciting aspect of liquid biopsy tests is the possibility of screening for many cancer types simultaneously and potentially with high specificity. If these procedures, called multicancer detection (MCDs) assays or multicancer early detection tests, are found to be effective, they may make receiving cancer screening easier for individuals. These tests may also decrease potential physical harm(s) from some of the conventional cancer screening tests, such as colonoscopy. Furthermore, a minimally invasive test that can be used to screen for multiple cancer types could transform early detection of cancers; potentially increase participation in cancer screening; and may decrease some current barriers to cancer screening. An ongoing study is evaluating the specificity and accuracy of an MCD test for more than 50 types of cancer. Findings thus far show that the test correctly identified two out of every three cancers in more than 5,000 people who had visited their health care providers with suspected symptoms. The test also correctly identified the site from which cancer originated in 85 percent of those cases (321). A recent modeling study using the cancer mortality data from England estimated that using MCDs would result in 17 percent fewer deaths from cancer per year (322). It is important to note that the research evaluating the safety and efficacy of MCD tests for routine cancer screening is at an early stage. While the initial studies are encouraging, currently there are limited data from prospective clinical studies (319,320). Key issues that remain unresolved include whether MCD tests can detect early stages of multiple cancer types accurately; what will be the rate of false positive results; whether using an MCD test will provide benefits that outweigh potential harms; and how much these tests will cost. Large ongoing studies, such as NCI’s Vanguard Trial, will answer some of these critically important questions. THE NATIONAL CANCER INSTITUTE'S (NCI) RESEARCH INITIATIVES TO ACCELERATE PROGRESS IN LIQUID BIOPSY AND MULTICANCER DETECTION APPROACHES • The Precompetitive Collaboration on Liquid Biopsy for Early-Cancer Assessment initiative is an academic-industrial partnership program, with the primary goal to address some of the existing challenges and to accelerate progress toward using liquid biopsy approaches for early cancer detection (323). • NCI’s Vanguard Trial is a large feasibility clinical study that will launch in 2024 and will recruit 24,000 participants to evaluate potential ways MCDs should be studied to determine whether or not they can be effective in screening for cancer (324). Screening for Early Detection AACR Cancer Progress Report 2023 67
RkJQdWJsaXNoZXIy NTkzMzk=