Feasibility of blood testing combined with PET-CT to screen for cancer and guide intervention

被引:450
作者
Lennon, Anne Marie [1 ,2 ,3 ]
Buchanan, Adam H. [4 ]
Kinde, Isaac [5 ]
Warren, Andrew [5 ,6 ]
Honushefsky, Ashley [4 ]
Cohain, Ariella T. [5 ]
Ledbetter, David H. [4 ]
Sanfilippo, Fred [7 ]
Sheridan, Kathleen [4 ]
Rosica, Dillenia [4 ]
Adonizio, Christian S. [4 ,8 ]
Hwang, Hee Jung [5 ]
Lahouel, Kamel [1 ,9 ]
Cohen, Joshua D. [1 ,2 ,10 ,11 ,12 ]
Douville, Christopher [1 ,11 ]
Patel, Aalpen A. [4 ]
Hagmann, Leonardo N. [5 ]
Rolston, David D. [4 ]
Malani, Nirav [5 ]
Zhou, Shibin [1 ,11 ]
Bettegowda, Chetan [1 ,11 ,13 ]
Diehl, David L. [4 ]
Urban, Bobbi [5 ]
Still, Christopher D. [4 ]
Kann, Lisa [5 ]
Woods, Julie I. [4 ]
Salvati, Zachary M. [4 ]
Vadakara, Joseph [4 ]
Leeming, Rosemary [4 ]
Bhattacharya, Prianka [4 ]
Walter, Carroll [4 ]
Parker, Alex [5 ]
Lengauer, Christoph [5 ,6 ]
Klein, Alison [1 ,2 ,14 ]
Tomasetti, Cristian [1 ,9 ,15 ]
Fishman, Elliot K. [1 ,2 ,16 ]
Hruban, Ralph H. [1 ,2 ,17 ]
Kinzler, Kenneth W. [1 ,2 ,11 ]
Vogelstein, Bert [1 ,2 ,10 ,11 ]
Papadopoulos, Nickolas [1 ,2 ,11 ,17 ]
机构
[1] Johns Hopkins Univ, Dept Oncol, Sidney Kimmel Canc Ctr, Sch Med, 733 N Broadway, Baltimore, MD 21205 USA
[2] Johns Hopkins Univ, Sch Med, Sol Goldman Pancreat Canc Res Ctr, 733 N Broadway, Baltimore, MD 21205 USA
[3] Johns Hopkins Univ, Sch Med, Dept Med, 733 N Broadway, Baltimore, MD 21205 USA
[4] Geisinger, 100 N Acad Ave, Danville, PA 17822 USA
[5] Thrive Earlier Detect Corp, 38 Sidney St, Cambridge, MA 02139 USA
[6] Third Rock Ventures LLC, 29 Newbury St, Boston, MA 02116 USA
[7] Emory Univ, Sch Med, Dept Pathol & Lab Med, 100 Woodruff Circle, Atlanta, GA 30322 USA
[8] Geisinger Canc Inst, 100 N Acad Ave, Danville, PA 17822 USA
[9] Johns Hopkins Univ, Dept Oncol, Sch Med, Div Biostat & Bioinformat, 733 N Broadway, Baltimore, MD 21205 USA
[10] Johns Hopkins Univ, Howard Hughes Med Inst, Sch Med, 733 N Broadway, Baltimore, MD 21205 USA
[11] Johns Hopkins Univ, Ludwig Ctr, Sch Med, 733 N Broadway, Baltimore, MD 21205 USA
[12] Johns Hopkins Univ, Dept Biomed Engn, Sch Med, 733 N Broadway, Baltimore, MD 21205 USA
[13] Johns Hopkins Univ, Dept Neurosurg, Sch Med, 733 N Broadway, Baltimore, MD 21205 USA
[14] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, 615 N Wolfe St, Baltimore, MD 21205 USA
[15] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Biostat, 615 N Wolfe St, Baltimore, MD 21205 USA
[16] Johns Hopkins Univ, Sch Med, Dept Radiol, 733 N Broadway, Baltimore, MD 21205 USA
[17] Johns Hopkins Univ, Sch Med, Dept Pathol, 733 N Broadway, Baltimore, MD 21205 USA
基金
美国国家卫生研究院;
关键词
DNA; PLASMA; QUANTIFICATION; STRATEGIES; MUTATIONS; DIAGNOSIS;
D O I
10.1126/science.abb9601
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Cancer treatments are often more successful when the disease is detected early. We evaluated the feasibility and safety of multicancer blood testing coupled with positron emission tomographycomputed tomography (PET-CT) imaging to detect cancer in a prospective, interventional study of 10,006 women not previously known to have cancer. Positive blood tests were independently confirmed by a diagnostic PET-CT, which also localized the cancer. Twenty-six cancers were detected by blood testing. Of these, 15 underwent PET-CT imaging and nine (60%) were surgically excised. Twenty-four additional cancers were detected by standard-of-care screening and 46 by neither approach. One percent of participants underwent PET-CT imaging based on false-positive blood tests, and 0.22% underwent a futile invasive diagnostic procedure. These data demonstrate that multicancer blood testing combined with PET-CT can be safely incorporated into routine clinical care, in some cases leading to surgery with intent to cure.
引用
收藏
页码:49 / +
页数:40
相关论文
共 65 条
[1]   Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening [J].
Aberle, Denise R. ;
Adams, Amanda M. ;
Berg, Christine D. ;
Black, William C. ;
Clapp, Jonathan D. ;
Fagerstrom, Richard M. ;
Gareen, Ilana F. ;
Gatsonis, Constantine ;
Marcus, Pamela M. ;
Sicks, JoRean D. .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 365 (05) :395-409
[2]   Universal cancer screening: revolutionary, rational, and realizable [J].
Ahlquist, David A. .
NPJ PRECISION ONCOLOGY, 2018, 2
[3]   The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging [J].
Amin, Mahul B. ;
Greene, Frederick L. ;
Edge, Stephen B. ;
Compton, Carolyn C. ;
Gershenwald, Jeffrey E. ;
Brookland, Robert K. ;
Meyer, Laura ;
Gress, Donna M. ;
Byrd, David R. ;
Winchester, David P. .
CA-A CANCER JOURNAL FOR CLINICIANS, 2017, 67 (02) :93-99
[4]   Adjuvant Fluorouracil, Leucovorin, and Oxaliplatin in Stage II to III Colon Cancer: Updated 10-Year Survival and Outcomes According to BRAF Mutation and Mismatch Repair Status of the MOSAIC Study [J].
Andre, Thierry ;
de Gramont, Armand ;
Vernerey, Dewi ;
Chibaudel, Benoist ;
Bonnetain, Franck ;
Tijeras-Raballand, Annemilai ;
Scriva, Aurelie ;
Hickish, Tamas ;
Tabernero, Josep ;
Van Laethem, Jean Luc ;
Banzi, Maria ;
Maartense, Eduard ;
Shmueli, Einat ;
Carlsson, Goran U. ;
Scheithauer, Werner ;
Papamichael, Demetris ;
Moeehler, Marcus ;
Landolfi, Stefania ;
Demetter, Pieter ;
Colote, Soudhir ;
Tournigand, Christophe ;
Louvet, Christophe ;
Duval, Alex ;
Flejou, Jean-Francois ;
de Gramont, Aimery .
JOURNAL OF CLINICAL ONCOLOGY, 2015, 33 (35) :4176-+
[5]  
[Anonymous], 2018, Behavioral risk factor surveillance system survey data
[6]  
[Anonymous], 2020, CANC DISCOV, DOI DOI 10.1111/CAS.14494
[7]   The emerging clinical relevance of genomics in cancer medicine [J].
Berger, Michael F. ;
Mardis, Elaine R. .
NATURE REVIEWS CLINICAL ONCOLOGY, 2018, 15 (06) :353-365
[8]   Detection of Circulating Tumor DNA in Early- and Late-Stage Human Malignancies [J].
Bettegowda, Chetan ;
Sausen, Mark ;
Leary, Rebecca J. ;
Kinde, Isaac ;
Wang, Yuxuan ;
Agrawal, Nishant ;
Bartlett, Bjarne R. ;
Wang, Hao ;
Luber, Brandon ;
Alani, Rhoda M. ;
Antonarakis, Emmanuel S. ;
Azad, Nilofer S. ;
Bardelli, Alberto ;
Brem, Henry ;
Cameron, John L. ;
Lee, Clarence C. ;
Fecher, Leslie A. ;
Gallia, Gary L. ;
Gibbs, Peter ;
Le, Dung ;
Giuntoli, Robert L. ;
Goggins, Michael ;
Hogarty, Michael D. ;
Holdhoff, Matthias ;
Hong, Seung-Mo ;
Jiao, Yuchen ;
Juhl, Hartmut H. ;
Kim, Jenny J. ;
Siravegna, Giulia ;
Laheru, Daniel A. ;
Lauricella, Calogero ;
Lim, Michael ;
Lipson, Evan J. ;
Marie, Suely Kazue Nagahashi ;
Netto, George J. ;
Oliner, Kelly S. ;
Olivi, Alessandro ;
Olsson, Louise ;
Riggins, Gregory J. ;
Sartore-Bianchi, Andrea ;
Schmidt, Kerstin ;
Shih, Ie-Ming ;
Oba-Shinjo, Sueli Mieko ;
Siena, Salvatore ;
Theodorescu, Dan ;
Tie, Jeanne ;
Harkins, Timothy T. ;
Veronese, Silvio ;
Wang, Tian-Li ;
Weingart, Jon D. .
SCIENCE TRANSLATIONAL MEDICINE, 2014, 6 (224)
[9]   Validation of a decision regret scale [J].
Brehaut, JC ;
O'Connor, AM ;
Wood, TJ ;
Hack, TF ;
Siminoff, L ;
Gordon, E ;
Feldman-Stewart, D .
MEDICAL DECISION MAKING, 2003, 23 (04) :281-292
[10]   Survival of patients with symptom- and screening-detected colorectal cancer [J].
Brenner, Hermann ;
Jansen, Lina ;
Ulrich, Alexis ;
Chang-Claude, Jenny ;
Hoffmeister, Michael .
ONCOTARGET, 2016, 7 (28) :44695-44704