Reports from the cancer front

Here’s an update and report on cancer research buy the Partnership Health Plan of California.

The Evolution of Cancer Research
While many people trace modern cancer research to President Nixon’s 1971 “War on Cancer,” the disease has affected humans for thousands of years, including in the ancient Egyptian Edwin Smith Papyrus dating back to around 1600 BCE.

In the past decade alone, oncologists, researchers and drug makers have made major breakthroughs in cancer treatment. Yet even though immunotherapies and surgeries have doubled the five-year survival rate in some cancers, catching cancer early by screening has not changed in years.

In fact, providers and patient advocates have found that due to changes in who is getting colon cancer, we have been waiting too late to screen. Younger people are being diagnosed with advanced colon cancer years before 50 years old; the age that, for years, was the recommended time to start colon cancer screening. Because of these changes in the epidemiology of cancer, the environment around when and how to screen is rapidly changing.

Current state of screening
Three major companies, Grail, Guardant Health, and Exact Sciences, have developed increasingly accurate, non-invasive cancer screening tests over the past decade.

For colon cancer, Exact Sciences developed Cologuard and Cologuard Plus, two tests that test patient stool for DNA associated with colon cancer and precancerous tissue.

In 2022, Guardant Health developed a blood-based colon cancer screening test and received FDA-approval in 2022. Both companies’ tests focus on finding colon cancer at early stages, when it is most treatable.

Grail, with its multi-cancer early detection test, is reaching much further than single cancer diagnoses. The company is currently considered the pioneer in what they described as the “liquid biopsy” space. Their MCED blood test called Galleri is able to detect DNA in the blood for over 50 types of cancer, including detecting many cancers at early, more treatable stages.

Recent developments
Despite significant gains in screening accuracy over the past decade, Grail has recently faced headwinds in the early cancer detection space.

A recent three-year clinical trial involving 142,000 participants in the UK found that the study missed its primary goal of demonstrating that the MCED test reduced the number of late stage (combined stage III and stage IV) cancer diagnoses.

However, the study did have several positive results: in people who used the test, this group was 20percent less likely to have the deadliest cancers (e.g., pancreatic cancer, lung cancer) diagnosed at Stage IV or diagnosed at a stage of emergency symptoms (e.g., coughing up blood, severe abdominal pain in pancreatic cancer). Furthermore, adding the MCED test to normal cancer screening, such as mammograms, increased the cancer detection rate four-fold.

Screening future
Thousands of years have passed since the earliest scientific writings describing human cancer. But recent developments suggest that it will be a much shorter time before, with new screening methods and treatments, we will be writing the epitaph on cancer.

Through increasingly more accurate screening tools, we are finding cancer earlier, treating it with more therapies, and helping patients live longer cancer free. Talk to your doctor to see if you are due for a cancer screening test.

About Dr. Kermit Jones
Dr. Kermit Jones is the deputy chief medical officer at Partnership HealthPlan of California.

About Partnership HealthPlan of California
Partnership HealthPlan of California is a community-based, safety-net health care organization that contracts with the state to administer Medi-Cal benefits. Partnership provides quality care to nearly 900,000 Medi-Cal members. Starting in Solano County in 1994, Partnership now serves 24 Northern California counties – Lassen, Butte, Colusa, Del Norte, Glenn, Humboldt, Lake, Marin, Mendocino, Modoc, Napa, Nevada, Placer, Plumas, Shasta, Sierra, Siskiyou, Solano, Sonoma, Sutter, Tehama, Trinity, Yolo and Yuba. Learn more about Partnership at PartnershipHP.org.