The Race For Early-Detection Cancer Screenings Heats Up

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The CDC estimates that 39.7 percent of the general population will be diagnosed with some form of cancer in their lifetime, resulting in an annual toll of more than 500,000 deaths and $125 billion in healthcare spending. For oncologists working on the front lines of cancer care, one of the most important predictors of mortality is how early a patient’s cancer was discovered. Breast cancer, for example, is the single most common cancer diagnosed in the US and aggressive treatment options have driven the survival rate for breast cancer to near 100 percent for patients whose cancer is discovered early. However, when breast cancer is not discovered until later survival rates plummet. Patients with Stage III breast cancer tumors only have a 72-percent survival rate, and patients diagnosed with stage IV tumors face a daunting a 22-percent survival rate.

For decades, public health campaigns have focused on promoting self-examinations and routine screenings to help ensure that tumors are found early, giving oncologists far better odds at a positive outcome. While these public health efforts have improved cancer detection rates in the US, many cancers, such as pancreatic cancer, have no standard screening tests and are often asymptomatic until it is simply too late to effectively treat the tumor. What oncologists desperately need is a single, standard screening test that can detect early stage cancers of all types. This kind of broad-based screening test is at the center of a number of high-profile research labs across the US, where oncologists are working with everything from DNA sequencing, to breathalyzers, to nanoparticles in their efforts to improve cancer screening.

This week, Illumina, the world’s largest manufacturer of DNA sequencing machines, announced an ambitious $100 million research and development project that will focus exclusively on developing a blood test capable of detecting any kind of cancer while it is still at an early stage. Illumina has created a spin-off company, called Grail, to lead and eventually commercialize the test. Illumina CEO Jay Flatley reports that he hopes to bring a test like this to market by 2019, an aggressive timeline considering that work is just now starting, but also a testament to how serious the team is about delivering on their promise of a catch-all screening test. Illumina’s test will leverage the fact that mutated DNA from cancer cells can be detected in the bloodstream, regardless of where the tumor is found in the body. By screening for mutated DNA in the bloodstream, researchers hope to develop a cancer screening test that could be included in annual physicals. The technique used to detect mutated DNA in the bloodstream was originally developed by chemical pathologist Yuk Ming Lo, working from the Chinese University of Hong Kong. Lo used the technique to develop a screening to test prenatal babies for Down syndrome. He is optimistic about using the technique for cancer screening: “It took 13 years to develop the prenatal tests, but the path was untrodden. Cancer will take a shorter time.”

Meanwhile, researchers at the National Institute for Materials Science have approached the same problem from a different angle, detecting cancer in exhaled breath. A team led by Genki Yoshikawa recently published promising findings from its own research. The team has created a breathalyzer-like device capable of detecting key biomarkers associated with cancer on exhaled breath. While the technology cannot differentiate between different types of cancers, the sensor is able to identify patients with cancer 87 percent of the time. The team behind the technology sees it being used both in healthcare settings and in consumer devices designed for at-home use. Moving forward, the team will continue working to improve the test’s sensitivity and to add the ability to identify specific types of cancers.

While Illumina and Yoshikawa are both pursuing solutions that would help make cancer screenings cheaper, more convenient, and far more effective at detection, Google’s Life Science Division is working on the same problem, but has taken a fundamentally different approach to solving it. Google has patented a pill packed with millions of microscopic nanoparticles that pass through the digestive tract and into the bloodstream, where they are designed to seek out cancer cells and then signal a fitness tracker-like device worn on the wrist if cancer is ever detected. The device represents a fundamental shift in cancer screening because the nanoparticles remain in the bloodstream indefinitely, where they actively monitor for cancer and detect tumors at the earliest possible stages. Google announced that the technology was being developed within its secretive Google X Labs in 2014, and has since been quiet about progress, but the effort is being led by world renowned biologist Andrew Conrad, who explains, "What we are trying to do is change medicine from reactive and transactional to proactive and preventative." If Google is successful in its effort, and the general public embraces the technology, public health officials could expect dramatic improvements to overall cancer survival rates.


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