New non-invasive method to detect lung cancer now in clinical trial

From ASCO Daily News

Comprehensive sequencing of plasma cell-free DNA (cfDNA) demonstrates the ability to non-invasively detect lung cancer with reliable specificity and sensitivity, according to preliminary data from the Circulating Cell-free Genome Atlas (CCGA) study presented  at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago in June, 2018.

Although the current screening paradigm for lung cancer in high-risk individuals calls for the use of low-dose CT, clinical adoption is low, at approximately 1.9%, presenter Geoffrey R. Oxnard, MD, of Dana-Farber Cancer Institute, said. Thus, “the cfDNA test offers an untapped opportunity for cancer detection,” he said.

Although plasma cfDNA genomic analysis is widely used in the management of advanced lung cancer, its suitability for early-stage lung cancer detection is not well established. Unlike its use in advanced cancer to find specific, actionable mutations, plasma cfDNA use to detect cancer instead requires the identification of a broader cancer signature rather than individual mutations, Dr. Oxnard said.

The CCGA study was designed to validate the use of cfDNA in the screening setting. It is a prospective longitudinal cohort study with a planned enrollment of 15,000 or more participants—30% without any type of cancer. Patients will be observed for up to 5 years. To date, the study has enrolled more than 12,000 participants at 142 sites in 24 states in the United States and one site in Canada.

“This incredible enrollment rate took less than 2 years and is reflective of the enthusiasm of patients and investigators in this research,” Dr. Oxnard said.

“Together, these results support the promise of using cfDNA-based assays to develop an early cancer detection test with high specificity,” Dr. Oxnard said.

“Any noninvasive approach would be a large improvement,” Discussant David Harpole Jr., MD, of Duke University Medical Center, said.

As with any cancer, early detection allows for much better outcomes than if the cancer is detected at a late stage, after it has spread to other parts of the body. Detecting lung cancer early increases the potential of 5 year survival to 55%.

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