Blood Test Promising as Colorectal Cancer Screen
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https://www.medpagetoday.com/meetingcoverage/ddw/86358
In a prospective study involving 354 patients at the VA Palo Alto medical center presenting for elective colonoscopy -- which served as the "gold standard" reference for presence of CRC and advanced adenomas -- 11 were found to have CRC and 53 to have advanced adenomas.
All of those with CRC and 40 of the patients with advanced adenomas scored as positive on the multimodal assay, Friedland reported -- thus showing sensitivity of 100% for CRC and 75.5% for advanced adenomas.
And among the 79 patients whose colonoscopies were negative for both cancer and adenomas, eight scored as positive on the assay, for sensitivity of 89.9%.
Findings with the multimodal test -- developed by a company called CellMax Life, which sponsored the study -- compared favorably to published data for currently available stool-based tests, according to Friedland. For example, while the Cologuard DNA test showed specificity virtually identical to the CellMax assay, its sensitivity was 92% for CRC and 42% for advanced adenomas. Specificity for a standard fecal immunochemical test is 96%, but its sensitivities are just 74% and 24% for CRC and advanced adenomas, respectively.
One important caveat is that patients in the study were not necessarily representative of the typical screening population -- as a VA sample, participants were overwhelmingly male. Their age distribution and other factors affecting CRC risk were not reported. Enrollment in the Stanford/VA study is continuing, Friedland said.
Still, Friedland suggested that the CellMax test could improve on existing alternatives to colonoscopy to improve screening rates. In his presentation, he noted that colonoscopy and CT colonography, while effective, are "inconvenient and expensive." Both involve awkward and unpleasant bowel cleansing as well. Stool-based tests, meanwhile, have not been as popular with patients as their developers had hoped, as the collection methods are somewhat particular and many people simply don't want to handle fecal matter.
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I heard about this last year when I was working for the Cologuard folks. My thought on them was 'yeah, you have the easier test now, but it is not as accurate as a 'scope and there are others out there working on better testing'. In other words, Cologuard will be a thing of the past in ten years and you had better find something else quick. I know they are working on a liver test as the next offering, but it is a blood test too, so not sure how innovative it really is. They bought Genomic Sciences while I was there so they now own Oncytype DX testing.
