Multicancer early detection with a spectroscopic liquid biopsy platform.

Abstract

3034 Background: A rapid, low-cost, sensitive, multi-cancer early detection (MCED) test would be transformational in the diagnostics field. Earlier cancer detection and instigation of treatment can increase survival rates. An effective test must accurately identify the small proportion of patients with typically non-specific symptoms who actually have cancer. Such symptoms don’t easily segregate by organ system, necessitating a multi-cancer approach. Methods: In this large-scale study ( n = 2094 patients) we applied the Dxcover Cancer Liquid Biopsy to differentiate cancer against non-cancer, as well as organ specific tests to identify cancers of the brain, breast, colorectal, kidney, lung, ovary, pancreas, and prostate. The test uses Fourier transform infrared spectroscopy to analyze all macromolecules in a minute volume of patient serum, and machine learning to build a classifier of the resultant spectral profiles for calling the likelihood of cancer. Results: For the overall cancer classification, our model achieved 90% sensitivity with 61% specificity when tuned for sensitivity, with detection rates of 93% for stage I, 84% for stage II, 92% for stage III and 95% for stage IV. We also tuned for maximum sensitivity or specificity, whilst the other statistic was fixed above a minimum value of 45%. This resulted in 94% sensitivity with 47% specificity, and 94% specificity with 48% sensitivity, respectively. For organ specific cancer classifiers area under the curve values were calculated for all cancers: brain (0.90), breast (0.74), colorectal (0.91), kidney (0.91), lung (0.90), ovarian (0.85), pancreatic (0.81) and prostate (0.85). Conclusions: Cancer treatment is often more effective when given earlier and this low-cost strategy can facilitate the requisite earlier diagnosis. With further development, the Dxcover MCED test could have a significant impact on early detection of cancer, which is vital in the quest for improved survival and quality of life.

Global serum profiling: an opportunity for earlier cancer detection

“…The Dxcover ® Cancer Liquid Biopsy is a serum-based spectroscopic liquid biopsy which generates a spectral signature that captures the full range of potential markers contained in human blood serum, encompassing both tumor and non-tumor derived signals rather than targeting individual biomarkers. With this approach, 64% of eight different stage I cancers (i.e., brain, breast, colorectal, lung, kidney, ovarian, pancreatic and prostate) were successfully detected at 99% specificity [ 95 ]. The technique can be fine-tuned to maximize either sensitivity or specificity depending on the requirements from different healthcare systems and cancer diagnostic pathways, since different intended uses will prioritize different test performance characteristics [ 96 ].…”

“…This study also tested a symptomatic patient cohort which may be more appropriate in a triage setting, where high sensitivity would be preferred to enable a ‘rule-out’ test. The sensitivity-tuned approach enabled the detection of 93% (214/231) of stage I and 84% (431/516) of stage II cancers, where overall specificity was 61% [ 95 ]. This liquid biopsy is not yet available to patients and large-scale clinical validation studies are required to further test its performance.…”