NEWS
OKLAHOMA CITY, OKLA. – Health professionals regularly screen for five types of cancer — breast, colon, lung, prostate and cervical — yet those five comprise only half of all cancer deaths. Researchers at the University of Oklahoma are studying a new blood test that potentially can identify more than 50 types of cancer, notably the ones that might otherwise go undetected until after the cancer has spread.
The clinical trial, offered at OU Health Stephenson Cancer Center, is studying a multi-cancer early detection test made by the company Grail. OU is among about 40 institutions across North America that are enrolling participants to determine how well the test can detect cancer and identify where it is in the body.
“This is an exciting trial because we know that catching cancer early saves lives. We are already seeing instances where the test finds a cancer at an early stage, when it is much more treatable,” said OU Health radiation oncologist Jerry Jaboin, M.D., Ph.D., professor and chair of the Department of Radiation Oncology in the OU College of Medicine. He is leading the trial with OU Health radiation oncologist Andrea Johnston, M.D., assistant professor in the department.
The trial is open to people ages 50 to 80 because aging itself is one of the biggest risk factors for cancer. Participants have their blood drawn and pathologists study the samples to determine if there is a “signal” for cancer and where it is originating from in the body. Those who receive a positive signal undergo follow-up diagnostic testing appropriate for the type of cancer suspected, such as imaging or further blood analysis. The costs of the follow-up testing are covered by the clinical trial.
“When someone has a positive finding, our health care professionals will usually find a tumor within 60 days if it is present,” Jaboin said. “If the person has a false positive, it usually takes four to six months to complete the work-up. Then we touch base with participants for the following three years.”
The Grail multi-cancer early detection test works first by determining if cancer cells are present. The body’s cells naturally release DNA into the bloodstream, and if cancer cells are present, they do the same. The Grail test spots the cancer cells because of their genetic dysfunction. Finding evidence of cancer isn’t helpful, however, unless researchers also know where it is located in the body. To determine the site of origin, the test analyzes methylation patterns, which signify that genes are being turned off or on.
“When we receive data from these tests, the patterns look like barcodes with light and dark areas. Through those patterns, we can say, ‘This cancer is probably from the colon’ or ‘This one is from the esophagus.’ With those two sets of information — the genetic abnormalities and the methylation patterns — we have a pretty good predictive model of where the tumor is coming from,” Jaboin said.
This is the second clinical trial to study this particular test. In the first trial, and thus far in the second, the patients who receive a signal for cancer go on to be officially diagnosed nearly 40% of the time. That rate is similar to cancer detected by colonoscopies and mammograms, Jaboin said.
Researchers are also collecting information about how trial participants react to a test that has the potential to detect multiple cancers. When people typically undergo cancer screening, they are only worried about one type of cancer, such as breast cancer.
“With this test, people don’t necessarily know what they should be worried about, so it probably comes with more stress than we realize,” Johnston said. “In health care, we are starting to better understand people’s mental states, how they’re handling information and how that impacts their overall quality of life. This trial is helping us to see what people are going through outside of our jobs of diagnosing and treating the cancer.”
Jaboin said the research staff has been intentional in its enrollment of all populations, including those historically underrepresented. The trial has also drawn the interest of groups of people who have a higher risk of cancer because of their careers, such as firefighters.
Although the Grail test is available commercially, insurance typically does not cover it, leaving patients to pay about $1,000 for the test itself and more for any follow-up diagnostic tests. Jaboin said the outcomes of this trial could help insurance companies decide future coverage.
This clinical trial offers a preview of many similar trials yet to come at OU Health Stephenson Cancer Center. Earlier this year, OU received a grant to join the National Cancer Institute’s new Cancer Screening Research Network to study promising new approaches for cancer screening; multi-cancer detection tests will feature prominently in the trials.
“It is exciting to do this work at an academic health center because we can implement new detection and treatment options sooner than other facilities can do,” Johnston said. “Meanwhile, we are teaching residents about these promising technologies, and they are taking that knowledge forward into their careers.”
For more information about the trial, call 405-271-8001, extension 33524.
About the University of Oklahoma
Founded in 1890, the University of Oklahoma is a public research university located in Norman, Oklahoma. As the state’s flagship university, OU serves the educational, cultural, economic and health care needs of the state, region and nation. OU was named the state’s highest-ranking university in U.S. News & World Report’s most recent Best Colleges list. For more information about the university, visit ou.edu.
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