Via Research Recognition Day Program VCOM-Carolinas 2025

Clinical Educational Research

Multicancer Early Detection Test Usage at Different NCCN and National Cancer Institute Designated Cancer Centers Maria Powers, OMS-II 1 , Smit Patel, OMS-II 1 , Samuel Kitchens, OMS-II 1 , Mrithika Pavan, OMS-II 1 , Amarinthia Curtis, MD 2 . 1. Edward Via College of Osteopathic Medicine- Carolinas Campus, Spartanburg, South Carolina. 2. Gibbs Cancer Center & Research Institute, Spartanburg, South Carolina.

Introduction

Results

Discussion

Multicancer Early Detection (MCED) tests assess for DNA or protein fragments in the blood that could detect cancer earlier than other current methods. This could improve mortality and morbidity rates in cancer patients. There have been many methods used to create a useful test, but there is only one commercially available MCED test currently which uses whole genome (WG) methylation. There are many limitations to MCED tests including but not limited to a lack of reliability due to the variability of tumors, false positives, false negatives, financial barriers, and more. This study researched MCED tests at different NCCN and National Cancer Institutes (NCI) Designated Cancer Centers. The objective of this study is to assess the level of use of MCED tests at various National Comprehensive Cancer Network (NCCN) and National Cancer Institute (NCI) Designated Cancer Centers. Considering the novelty and limited commercially available products, it was postulated that MCED tests would not be used at NCCN and NCI Cancer Centers. The public-facing website of every NCCN and National Cancer Institute (NCI) Designated Cancer Center institution was queried regarding MCED test information and clinical use. The descriptions for each NCI Designated Cancer Center were screened for the following keywords: MCED, Multi Cancer Early Detection, Galleri, cfDNA, and Multi Cancer Detection. After accessing each website, the same keywords were searched for on each website in addition to search engines. Specific information on mention of benefits, mention of cautions, mention of types of tests, and mention of dedicated MCED clinics was collected. Methods

This study found that 15 out of the 74 NCI Designated Cancer Centers, or the 15 positive centers, mentioned MCED tests within their public website. 12 of these positive centers are NCCN Centers. Of the 15 positive centers, 2 centers (Dana-Farber Cancer Center, in Boston, Massachusetts, and the Knight Cancer Institute, in Portland, Oregon) have MCED clinics (1 of which, Dana Farber is an NCCN Center). Two centers (Rogel Cancer Center in Ann Arbor, Michigan, and Huntsman Cancer Institute, in Salt Lake City, Utah) caution patients on MCED test use due to the risks of MCED tests (both of which are NCCN Centers). Overall, MCED tests are being researched in multiple places, but few centers are using MCED tests in clinics. Moreover, most of the 74 NCI Designated Cancer Centers do not have any public information that is mentioned on MCED tests. See Figure 1 for a summary of the results.

• Most centers do not mention MCED testing or research • A larger percentage of NCCN Centers mention MCED testing or research, but it is still not the majority • The majority of cancer centers that mention MCED tests are only conducting research with several cancer centers incorporating them into clinical trials • Very few NCI Designated Cancer Centers have integrated MCED tests into their regular clinical practice, only one of which is an NCCN Center. • There is a significant overlap between NCCN Centers and NCI Designated Cancer Centers that mention MCED tests, indicating a shared focus on advanced cancer care and research. Conclusions • Despite research interest, clinical adoption of MCED tests is still limited. • There is a large need for further research and careful evaluation before widespread clinical implementation. • Further research and clinical trials are required to fully realize the potential benefits and harms of MCED tests. • There are limitations to this study including a lack of an exhaustive word search list, a lack of certainty of research not publicized, and unknown recent updates of websites.

References

1. Fillon , Mike. “MCED blood test boosts cancer detection in symptomatic patients.” American Cancer Society, 4 Nov. 2023, acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21815/. 2. Jamshidi , Arash, et al. “Evaluation of Cell -Free DNA Approaches for Multi- Cancer ...” Cancer Cell, 17 Nov. 2022, www.cell.com/cancer-cell/pdf/S1535-6108(22)00513-X.pdf. 3. Lin, Danfeng , et al. “Circulating tumor cells: Biology and clinical significance.” Signal Transduction and Targeted Therapy, vol. 6, no. 1, 22 Nov. 2021, https://doi.org/10.1038/s41392-021-00817-8. 4. Pons-Belda , Oscar D., et al. “Multi Cancer Early Detection by Using Circulating Tumor DNA -the Galleri Test. Reply to Klein et al.. the Promise of Multicancer Early Detection. Comment on ‘Pons -Belda et al.. Can Circulating Tumor DNA Support a Successful Screening Test for Early Cancer Detection? The Grail Paradigm. Diagnostics 2021, 11, 2171.’” MDPI, Multidisciplinary Digital Publishing Institute, 17 May 2022, www.mdpi.com/2075-4418/12/5/1244. 5. Zhang, Kai et al. “Circulating cell -free DNA-based multi- cancer early detection.” Trends in cancer vol. 10,2 (2024): 161 -174. https://doi.org/10.1016/j.trecan.2023.08.010

Acknowledgements

Figure 1. A summary of the positive cancer centers and whether or not they are NCCN Centers. “ - ” not found on website

2025 Research Recognition Day

28