Liquid Biopsy/Blood Test
Researchers led by Bert Vogelstein, M.D., Johns Hopkins Kimmel Cancer Center, are designing a blood test called CancerSEEK that can detect the presence of pancreatic cancer as well as ovary, liver, stomach, esophagus, colorectal, lung and breast cancers. The test has the capacity not only to identify the presence of early cancer, but also to identify the organ where it came from. Developing a blood screening test for pancreatic cancer will significantly help long-term survival.
The test results for detecting pancreatic cancer are very promising. The sensitivity of the detection method was 72% and the specificity was greater than 99%. Sensitivity and specificity are terms used to evaluate a clinical test. Sensitivity is the ability of a test to correctly identify those with the disease (true positive), whereas test specificity is the ability of the test to correctly identify those without the disease (true negative). New blood tests for cancer must have very high specificity; otherwise, too many healthy individuals will receive false positive test results, leading to unnecessary follow-up procedures and anxiety.
This test is so critical because these eight cancers account for more than 60% of cancer deaths, and pancreatic cancer and four others in the panel have no screening test available. This study lays the foundation for a single blood screening test for multiple cancers that could be offered as part of routine medical checks. The estimated cost for the test will eventually be less than $500, which is comparable to or lower than other screening tests for single cancers, such as a colonoscopy. While further studies are necessary to establish the clinical utility of CancerSEEK and demonstrate that it can save lives, this test marks a significant first step toward a new era in how pancreatic cancer is diagnosed. The next steps are to increase the sensitivity of CancerSEEK and to test it on high-risk patients, which the Foundation is funding.
Screening High-Risk Individuals
As part of the Pancreatic Cancer Collective, the Interception Dream Team, which we fund along with Stand Up To Cancer, is identifying people at high risk for developing pancreatic cancer based on family history and “intercepting” the cancer in those high-risk people. The team – from six renowned institutions — is testing 2,000 pancreatic cancer patients for heritable mutations and screening their immediate family members for potential pancreatic cancer risk. The team will also apply a mathematical formula for developing improved imaging tools for early diagnosis of pancreatic cancer in high-risk groups and collaborate with the team that is working on CancerSEEK.
Screening for pancreatic cancer is also underway through the Cancer of the Pancreas Screening – 5 (CAPS -5) Study, funded by the National Institutes of Health and the American Association for Cancer Research. The CAPS -5 Study focuses on people who have a high risk for the disease due to a family history or genetic mutation and provides pancreatic cancer surveillance using a combination of endoscopic ultrasonography, MRIs, and CT scans. The CAPS – 5 Study is being conducted at Case Comprehensive Cancer Center (Cleveland, OH); Columbia University Medical Center (New York, NY); Dana-Farber Cancer Institute (Boston, MA); Johns Hopkins Hospital (Baltimore, MD); University of Michigan (Ann Arbor, MI); University of Pennsylvania (Philadelphia, PA); University of Pittsburgh (Pittsburgh, PA); and Yale University (New Haven, CT).
For more information, including eligibility criteria and contact information for each participating center, visit https://clinicaltrials.gov/ct2/show/NCT02000089.
Dr. Vogelstein’s other earlier detection project involves bringing together scientists from a broad range of disciplines such as radiology, physics, and vision science, which encompasses areas including how visual information is understood and how artificial systems can also process this information. This project is focused on using computers to recognize patterns in medical images just like driverless cars can identify roads, traffic and people. In this case, the hope is to apply advanced technology to CT and MRI images to detect the subtle early changes of pancreatic malignancy that a diagnostician may miss in order to find tumors either when they are smaller or missed by the human eye. As a result of this project, researchers hope that patients’ pancreatic cancer tumors will be detected earlier.
“Years from now, deaths from pancreatic cancer will be less common and that’s going to be in large part due to earlier detection.” -Bert Vogelstein, M.D., Distinguished Scholar