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

Science. 2020 Jul 3;369(6499):eabb9601. doi: 10.1126/science.abb9601. Epub 2020 Apr 28.

Authors

Anne Marie Lennon^#^{1

2

3}, Adam H Buchanan^#⁴, Isaac Kinde^#⁵, Andrew Warren^#^{5

6}, Ashley Honushefsky^#⁴, Ariella T Cohain⁵, David H Ledbetter⁴, Fred Sanfilippo⁷, Kathleen Sheridan⁴, Dillenia Rosica⁴, Christian S Adonizio^{4

8}, Hee Jung Hwang⁵, Kamel Lahouel^{1

9}, Joshua D Cohen^{1

2

10

11

12}, Christopher Douville^{1

11}, Aalpen A Patel⁴, Leonardo N Hagmann⁵, David D Rolston⁴, Nirav Malani⁵, Shibin Zhou^{1

11}, Chetan Bettegowda^{1

11

13}, David L Diehl⁴, Bobbi Urban⁵, Christopher D Still⁴, Lisa Kann⁵, Julie I Woods⁴, Zachary M Salvati⁴, Joseph Vadakara⁴, Rosemary Leeming⁴, Prianka Bhattacharya⁴, Carroll Walter⁴, Alex Parker⁵, Christoph Lengauer^{5

6}, Alison Klein^{1

2

14}, Cristian Tomasetti^{1

9

15}, Elliot K Fishman^{1

2

16}, Ralph H Hruban^{1

2

17}, Kenneth W Kinzler^{18

2

11}, Bert Vogelstein^{18

2

10

11}, Nickolas Papadopoulos^{18

2

11

17}

Affiliations

¹ Department of Oncology, the Sidney Kimmel Cancer Center, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
² The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
³ Department of Medicine Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
⁴ Geisinger, 100 N. Academy Avenue Danville, PA 17822, USA.
⁵ Thrive Earlier Detection Corp., 38 Sidney Street Cambridge, MA 02139, USA.
⁶ Third Rock Ventures, LLC, 29 Newbury Street Boston, MA 02116, USA.
⁷ Department of Pathology and Laboratory Medicine, Emory University School of Medicine, 100 Woodruff Circle Atlanta, GA 30322, USA.
⁸ Geisinger Cancer Institute, 100 N. Academy Avenue Danville, PA 17822, USA.
⁹ Division of Biostatistics and Bioinformatics, Department of Oncology, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
¹⁰ The Howard Hughes Medical Institute, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
¹¹ The Ludwig Center, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
¹² Department of Biomedical Engineering, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
¹³ Department of Neurosurgery, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
¹⁴ Department of Epidemiology, the Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street Baltimore, MD 21205, USA.
¹⁵ Department of Biostatistics, the Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street Baltimore, MD 21205, USA.
¹⁶ Department of Radiology, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD, 21205, USA.
¹⁷ Department of Pathology, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
¹⁸ Department of Oncology, the Sidney Kimmel Cancer Center, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA. npapado1@jhmi.edu vogelbe@jhmi.edu kinzlke@jhmi.edu.

^# Contributed equally.

Abstract

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 tomography-computed 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.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged
Cohort Studies
Early Detection of Cancer / methods*
Female
Hematologic Tests*
Humans
Mass Screening / methods*
Neoplasms / blood*
Neoplasms / diagnostic imaging*
Positron Emission Tomography Computed Tomography*

Abstract

Publication types

MeSH terms

Grants and funding