On April 11, 2022 Freenome, a privately held biotech company, reported that it will present research at the American Association for Cancer Research (AACR) (Free AACR Whitepaper) Annual Meeting that measures the clinical impact of detecting precancerous adenomas for tests that screen for colorectal cancer (CRC), including multi-cancer early detection (MCED) tests (Press release, Freenome, APR 11, 2022, View Source [SID1234612009]). The research modeled detecting adenomas and cancer (prevention and interception) or primarily cancer alone (interception) for such tests.
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The research found that even modest improvements in detecting adenomas resulted in more favorable CRC clinical outcomes than detecting primarily cancer alone. Since different cancers have different preclinical phases, the clinical utility of detecting precancerous lesions varies accordingly.[1] In CRC, detection and removal of adenomas and early-stage CRC significantly reduces CRC incidence and mortality.[2]
Using Freenome’s validated model, CRC-MAPS, researchers simulated adherence to an annual, blood-based CRC screening test among average-risk adults aged 45-75. Four scenarios were modeled:
A cancer interception test with clinical performance comparable to or better than that reported for some MCED tests3,4
A cancer interception test with near-perfect performance
Two cancer prevention and interception scenarios with varying adenoma sensitivity
A threshold analysis was also performed to determine the ≥10mm adenoma sensitivity needed for a cancer prevention and interception test to result in the same CRC mortality reduction as a near-perfect cancer interception test.
The results demonstrated that the cancer prevention and interception scenarios resulted in outcomes 2.3 to 5.6 times more favorable than the cancer interception scenarios due to increased adenoma detection. Further, the threshold analysis found that increasing the ≥10mm adenoma sensitivity by less than one (1) percentage point, from 1% to 1.94%, resulted in the same reduction in CRC mortality as the near-perfect interception test.
"This study shows the clinical impact of detecting adenomas in any test that screens for CRC," said Girish Putcha, M.D., PhD., lead author of the study and senior vice president, Freenome. "This is just one example of how clinical performance requirements vary by cancer, and why it’s important to consider each cancer separately when it comes to helping patients and improving health outcomes."