Detecting Cancer Earlier – UK to Pilot Blood Test with 165,000 Patients

Grail

Photo courtesy of Grail.

The best chance to stop one of the world’s deadliest diseases is through early detection. Organizations like the World Heath Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have been promoting cancer screenings for decades for early diagnosis. Yet too many cancers still remain undiagnosed until it’s too late.

California-based Grail aims to alter the devastating trajectory of cancer mortality with the addition of one simple blood test. Through a partnership with the UK’s National Health Service (NHS), confirmation of the test, Galleri, is anticipated through a program involving approximately 165,000 participants. 

An earlier version of the Galleri test was able to detect over 50 types of cancer with a less than 1% false positive rate through a single blood draw in a U.S. validation study.  

“Every year, nearly 200,000 people in the UK die from cancer. Many of these people are diagnosed too late for treatment to be effective,” said Lord David Prior, Chair of NHS England. “This collaboration between the NHS and GRAIL offers the chance for a wide range of cancers to be diagnosed much earlier and could fundamentally change the outlook for people with cancer.” 

The pilot program will enroll 140,000 between 50 and 79 who have no symptoms of cancer to receive annual blood tests over three years. Early detection gives patients their best chance, particularly for cancers with high mortality rates like ovarian and pancreatic. The other 25,000 participants will be identified through their doctor after presenting with possible cancer symptoms, such as a lump or discharge. The blood test will be offered to them in addition to further diagnostic testing.  

In the U.S., around 4,900 Americans are diagnosed with cancer every day and an estimated 606,520 people will die from the disease this year.  

Chief executive of Target Ovarian Cancer, Annwen Jones, said, "At the moment two-thirds of women with ovarian cancer are diagnosed late when the cancer is much harder to treat. This test, if proven to be effective, could be a major turning point in diagnosing ovarian cancer in this country, saving thousands of lives every year." 

The UK program is scheduled to start mid-2021 with results expected by 2023. With proof of efficacy, the hope is to expand the testing to one million by 2025 and beyond from there.  

Galleri works by looking for signals of cancer that may be present. If a cancer signal is detected, the test is designed to identify the location in the body where the signal is coming from the then identify the cancer type. A positive test would help a provider know what other tests are needed to confirm the presence of cancer.  

While some viewed the previous 6,689 participant Galleri pilot study results as very encouraging, others are not yet convinced.  

"The Galleri blood test is a test that might be able to detect cancer in the blood in individuals with early cancer, though the evidence that it does this effectively is weak," he said. "The NHS should not be investing in such a test before it has been adequately evaluated in well-conducted, large-scale clinical trials." 

Yet, Grail said in a press release that according to modeling data, "adding Galleri to existing standard of care has the potential to decrease the number of cancers diagnosed at late stage by nearly half, which could reduce the total number of cancer deaths in the UK by approximately one-fifth." 

However, most experts agree that early diagnosis is essential to improving cancer outcomes and is an important public health strategy. The results of this partnership should reveal if Grail’s Galleri test has the potential to become part of a standard of care in preventative screening for cancer.  

Professor Peter Johnson, national clinical director for cancer at NHS England and improvement said, “The NHS has set itself an ambitious target, to find three-quarters of cancers at an early stage, when they have the highest chance of cure. Tests like this may help us get there far faster, and I am excited to see how this cutting-edge technology will work out, as we test it in clinics across the NHS.”
 

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