Research Spotlight: Emerging Role of Blood-Based Cancer Detection Tests

Editor's note: The "Research Spotlight" series is written by Dr. Anna Berkenblit, PanCAN's Chief Scientific and Medical Officer. Each month, Dr. Berkenblit shares her insights into the latest news and research in pancreatic cancer. Follow Dr. Berkenblit on X and LinkedIn.

Spring is in the air, which means a special time for PanCAN. Each April, communities across the country come together for PanCAN PurpleStride, an inspiring day to celebrate survivors, honor those we lost, and turn the nation purple in support of pancreatic cancer awareness. This year, I'm looking forward to joining both the Rhode Island event on Saturday, April 25, and the Boston event on Sunday, April 26, standing alongside these communities in the shared mission to end pancreatic cancer.

Before we dive into this month's topic (blood-based cancer detection tests), I must give a shout out about some very exciting news from Revolution Medicines earlier this week. (Learn more on our blog.) The results from their Phase III clinical trial for patients with previously treated metastatic pancreatic cancer are truly remarkable. Those who received a pill called daraxonrasib lived approximately twice as long as those who received standard of care intravenous chemotherapy, with a median overall survival of 13.2 months versus 6.7 months, respectively. This new therapy targets RAS mutations present in more than 90% of patients with pancreatic adenocarcinoma, the most common type of pancreatic cancer. I'm really looking forward to seeing all the data from this groundbreaking trial, likely at the American Society of Clinical Oncology (ASCO) meeting at the end of May. And stay tuned for our next webinar in June, "KRAS and Pancreatic Cancer: Entering a New Era of Treatment," a round-up after ASCO that will focus on RAS inhibitors and what's next for pancreatic cancer.

While RAS inhibitors are ushering in a new era for the treatment of patients with advanced disease, we also know that to truly move the needle, for survival to be the expectation not the exception, better early detection strategies are needed. This month's Research Spotlight focuses on the latest in blood-based cancer detection tests.

Emerging Role of Blood-Based Cancer Detection Tests

Blood-based tests are beginning to be incorporated into strategies for early detection of pancreatic cancer, particularly in surveillance clinics for people at high risk. These minimally invasive tests are intended to identify potential signals of cancer before symptoms arise. While this is still evolving, blood-based screening represents one of the most promising opportunities for progress, particularly for pancreatic cancer, where early detection is elusive, with fewer than 20% of pancreatic cancers diagnosed early enough for surgery.

These blood tests work by analyzing biomarkers in the bloodstream, primarily circulating tumor DNA and proteins shed by cancer cells. By detecting these signals, clinicians may be able to identify cancer at an earlier, more treatable stage, leading to better outcomes.

Blood tests such as ClearNote Health's Avantect® and Immunovia's PancreaSureTM represent the next generation of targeted screening tools. They measure biomarkers associated with pancreatic cancer. By focusing on high-risk individuals, such as those with a family history of pancreatic cancer, genetic predisposition or new-onset diabetes, applying these tests aims to identify the disease when it is most treatable.

Beyond single cancer blood tests, multi-cancer early detection (MCED) tests are expanding the field with the goal of detecting multiple cancer types from a single blood draw. Blood tests such as GRAIL's Galleri®, Exact Sciences' Cancerguard®, and 20/20 BioLabs' OneTestTM for Cancer analyze patterns in tumor DNA seeking to identify the presence of up to 50 cancer types. This is particularly promising for cancers that lack early screening options, including pancreatic cancer.

While all these tests are commercially available to the public, they all require a healthcare provider to order, prescribe, or authorize it. It is important to also recognize that there are limitations. Blood-based tests may miss some cancers or result in false positives (leading to additional potentially invasive tests that show no cancer), and the tests are not diagnostic on their own. Because we still have a lot to learn about the best use of these tests, they are not covered by insurance.

Recent large-scale studies, including the NHS-Galleri trial, suggest that while MCED tests can shift diagnosis toward earlier stages, demonstrating a clear reduction in late-stage disease and improving survival will require continued study. We applaud companies that are doing large studies to understand the benefit of these tests in relevant populations.

Looking ahead, we will continue to see further development in blood-based screening strategies. Though not yet incorporated into standard clinical protocols, as more evidence is gathered and tests' abilities to correctly identify signals showing the presence of cancer improve, there can be potential for use among high-risk groups to determine which patients might benefit from further workup, including imaging, even if they have no symptoms. Research is also ongoing that focuses on the integration of AI with finding blood-based clues or patterns that may signify the early presence of cancer.

Bottom line is that blood-based cancer detection is not a replacement for other established screening but instead is an important step towards personalized screening strategies and proactive approaches. For pancreatic cancer, where early detection is challenging, blood tests offer meaningful hope. We no longer wonder if we can detect cancer in the blood; now we want to focus on how to do so in a way that offers meaningful outcomes for patients.