A University of Oxford study published today in Clinical Cancer
Research, a journal of the American Association for Cancer
Research, outlines a new type of blood test that can be used to
detect a range of cancers and whether these cancers have spread
(metastasised) in the body.
The study analysed samples from 300 patients with non-specific
but concerning symptoms of cancer, such as fatigue and weight
loss, who were recruited through the Oxfordshire Suspected CANcer
(SCAN) pathway.
The researchers assessed whether the test could distinguish
patients with a range of solid tumours from those without cancer.
Their results show that cancer was correctly detected in 19 out
of every 20 patients with cancer using this test. In those with
cancer, metastatic disease was identified with an overall
accuracy of 94%. These results make this the first technology to
be able to determine the metastatic status of a cancer from a
simple blood test, without prior knowledge of the primary cancer
type.
This test shows promise to help clinicians detect cancer and
assess cancer stage in the future. Unlike many blood-based tests
for cancer, which detect genetic material from tumours, this test
uses a technique called NMR metabolomics, which uses high
magnetic fields and radio waves to profile levels of natural
chemicals (metabolites) in the blood. Healthy individuals, people
with localised cancer, and people with metastatic cancer each
have different profiles of blood metabolites, which can be
detected and then analysed by the researchers’ algorithms to
distinguish between these states.
Dr James Larkin, researcher on the study from the University of
Oxford, says: “Cancer cells have unique metabolomic fingerprints
due to their different metabolic processes. We are only now
starting to understand how metabolites produced by tumours can be
used as biomarkers to accurately detect cancer. We have already
demonstrated that this technology can successfully identify if
patients with multiple sclerosis are progressing to the later
stages of disease, even before trained clinicians could tell. It
is very exciting that the same technology is now showing promise
in other diseases, like cancer.”
Cancers detected earlier are more likely to be treated
successfully. This rapid and inexpensive test could help to
overcome many barriers to the early detection of cancer,
especially in patients that present with non-specific symptoms,
which do not direct investigations towards a specific organ. NHS
Rapid Diagnostic Centres, similar to Oxfordshire’s SCAN pathway,
are currently being set up across the NHS to support faster and
earlier cancer diagnosis in all patients with symptoms that could
indicate cancer.
This new test is not specific to a single cancer type and has
shown promise in this traditionally challenging clinical context,
including the potential to detect some cancers in the community
before conventional imaging is performed.
Dr Fay Probert, lead researcher of the study from the University
of Oxford, says: “This work describes a new way of identifying
cancer. The goal is to produce a test for cancer that any GP can
request. We envisage that metabolomic analysis of the blood will
allow accurate, timely and costeffective triaging of patients
with suspected cancer, and could allow better prioritisation of
patients based on the additional early information this test
provides on their disease.”
Future studies with larger patient cohorts will further evaluate
this technique for the earlier detection of new cancers and
potential clinical applications.
Notes
This research was published in Clinical Cancer Research and can
be read here: http://clincancerres.aacrjournals.org/content/early/2021/12/16/1078-0432.CCR-21-2855
This research was funded by Cancer Research UK, the Oxford Centre
for Early Cancer Detection (OxCODE), the EPSRC Cancer Imaging
Centre in Oxford, the National Institute for Health Research
(NIHR) Community Healthcare Medtech and In-Vitro Diagnostics
Co-operative, and the OxfordWellcome Institutional Strategic
Support Fund.
