140,000 join world’s largest trial of blood tests to spot cancers before symptoms emerge
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Some 140,000 people are joining the world’s largest clinical trial of the test, which looks for fragments of tumour DNA. It can even pinpoint the likely location of the disease. Medics hope the Galleri checks will help them catch far more cases at an early stage of growth, when any treatment is more likely to be successful.
Writing in the Daily Express, NHS chief executive Amanda Pritchard says: “Today marks a really promising moment for the detection of cancer both here and around the world.The first patients will start to receive the revolutionary Galleri blood test which can, incredibly, detect cancer in the blood before symptoms even appear. There is good evidence that the test works, and the NHS is now getting to work putting it into place in a real-life setting, for the first time.
“Treatment can start more quickly, and we can get one step ahead of cancer.”
Cells jettison DNA fragments into the bloodstream, where the Galleri test can pick up abnormalities released by cancerous ones.
Research has shown it is particularly effective at finding cancers that can be hard to diagnose early, including head, neck, bowel, lung, pancreatic and throat tumours.
A study involving 4,000 people suggested Galleri identified when cancer was present in 51.5 percent of cases, giving a false positive result in only 0.5 percent.
With solid tumours that are not screened for currently ‑ such as oesophageal and liver cancers ‑ the test was even more sensitive, detecting 66 per cent of cases.
It also showed accurately where tumours were in the body in 89 percent of positive cases.
Patients whose cancers are caught early, at Stage 1 or 2, typically have a larger number of potential treatments available to them, which may include less aggressive therapies.
A person whose cancer is found at the earliest stage has a five to 10 times better chance of surviving compared with those who are diagnosed late at Stage 4.
Health Secretary Sajid Javid said: “The UK’s world-leading scientists continue to pioneer innovative cancer diagnosis and treatments.
“So our brilliant NHS staff have the tools to spot the disease as early as possible and give people the care they need.
“Early diagnosis can save lives and this revolutionary new test can detect cancers before symptoms even appear, giving people the best possible chance of beating the disease.
“Ensuring fewer people need treatment for advanced cancer is vital for patient care and another example of the NHS innovating to be more efficient ‑ which will be crucial in bringing down the [treatment] backlog.”
The NHS-Galleri trial is being run by the Cancer Research UK and King’s College London Cancer Prevention Trials Unit in partnership with the health service and healthcare company GRAIL, which developed the test technique.
Medics will contact tens of thousands of people aged from 50 to 77 of different backgrounds and ethnicities, inviting them to take part.
Patients are being recruited from several areas of England: Cheshire and Merseyside, Cumbria, Greater Manchester, the North East, West Midlands, East Midlands, East of England, Kent and Medway, and South East London.
They must not have had a cancer diagnosis in the last three years.
Triallists will be asked to attend a mobile clinic sited in retail parks and at other convenient locations to provide blood samples three times over the following two years.
Half will have their blood screened immediately, while samples from the rest will be stored and may be tested later.
This would allow scientists to compare rates of cancer diagnosis between those who were screened and those who were not, to determine how effective the test is.
Patients will find out they are in the test group if Galleri flags up possible cancer, in which case they will be sent to hospital to undergo further checks.
Prof Charles Swanton, a lead investigator in the trial, said that in these cases the hospital specialist will receive a report “indicating, with a high degree of accuracy, the location of the suspected cancer”.
He continued: “The numbers referred from this trial across England are likely to be small and would include people who might otherwise present at a later date with cancer that is more difficult to treat.”
All patients will also be asked to continue with their usual NHS screening appointments.
Initial results are expected by 2023. If they are successful, Galleri will be rolled out to a further one million people in 2024 and 2025.
The procedure is available now on prescription in the US but has not yet been granted full approval by the country’s Food and Drug Administration.
Dame Cally Palmer, NHS National Director for Cancer, said: “It is an absolute priority to speed up the earlier detection of cancer to improve survival, and this trial has the potential to do just that across a range of types of cancer.
“We are very grateful to all the people who will be taking part in this important initiative, which could help us save many more lives in the future.”
Prof Peter Sasieni, co-lead investigator, said: “We need to study the Galleri test carefully to find out whether it can significantly reduce the number of cancers diagnosed at a late stage. The test could be a game-changer for early cancer detection and we are excited to be leading this important research.”
He added: “Cancer screening can find cancers earlier when they are more likely to be treated successfully, but not all types of screening work.”
GRAIL is covering the costs of testing for the trial.
Sir Harpal Kumar, president of GRAIL Europe, said: “We’re delighted to partner with the NHS to support the NHS Long Term Plan for earlier cancer diagnosis.
“We are eager to bring our technology to people in the UK as quickly as we can.”
Sir Harpal continued: “The Galleri test can not only detect a wide range of cancer types but can also predict where the cancer is in the body with a high degree of accuracy.
“The test is particularly strong at detecting deadly cancers and has a very low rate of false positives.”
A separate trial led by the University of Oxford is recruiting up to 25,000 patients with cancer symptoms, to see if the blood test can accelerate diagnosis of suspected cases.
Everyone can play a part to save lives
Comment by Amanda Pritchard
Every day, up to 1,000 people across the country are newly diagnosed with cancer. For patients and their families, a diagnosis is devastating.
But we know that someone whose cancer is diagnosed at the earliest stage typically has between five and 10 times the chance of surviving compared with those found at the latest stage.
This is why today marks a really promising moment for the detection of cancer both here and around the world.
The first patients will start to receive the revolutionary Galleri blood test which can, incredibly, detect cancer in the bloodstream before symptoms even appear.
There is good evidence that the test works, and the NHS is now getting to work putting it into place in a real-life setting for the first time.
From today, NHS staff will start taking this potentially life-saving blood sample from people in Runcorn and London, with six more sites to follow over the next few weeks.
NHS staff have gone to great lengths to ensure cancer treatment for patients could continue for patients during the pandemic.
And it is thanks to their huge efforts that cancer services are now back at usual levels.
The most recent figures show that in just one month, more than 200,000 people were checked for cancer, and more than 27,000 started treatment.
We know that lives are saved when cancers are caught early, which is why the NHS has put so much effort into early diagnosis in recent years.
And now, with this test, not only can we spot the classic warning signs of cancer, but the invisible signs of killer disease can be revealed to clinicians.
This means treatment can start more quickly, and we can get one step ahead of cancer.
The NHS Long Term Plan commits to catching three-quarters of cancers at stages one and two, up from half at present, and this worldfirst trial could help us with those ambitions.
But you can help us too. If you or your family are worried about a symptom, please contact your GP.
We want you to help us save lives.
And, if you are invited to take part in this trial, please come forward.
You could be helping us to revolutionise how we catch and treat cancer in the years to come.
Amanda Pritchard is NHS Chief Executive
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