New blood test identifies metastatic status of cancer

A new minimally invasive and inexpensive blood test can detect a range of cancers in patients with non-specific symptoms, and can indicate whether the cancer has spread

The blood test is to be used to detect a range of cancers and whether these cancers have spread, or metastasised, in the body.

The study analysed samples from 300 patients with cancer symptoms, some of which were non-specific, who were recruited through the Oxfordshire Suspected CANcer (SCAN) pathway. Their symptoms ranged from fatigue to weight loss.

Published in Clinical Cancer Research, the researchers assessed whether the test could distinguish patients with a range of solid tumours from those without cancer.

Test can find metastatic status of a cancer, from a blood test

Cancer was correctly detected in 19 out of every 20 patients using this test. For those with cancer, metastatic disease was identified with an overall accuracy of 94%. These results show the success of the blood test, determining the metastatic status of a cancer without prior knowledge of the primary cancer type.

With this test, clinicians can detect cancer and assess cancer stage, using a technique called NMR metabolomics, which uses high magnetic fields and radio waves to profile levels of natural chemicals (metabolites) in the blood. This innovation is unlike many other blood-based tests for cancer, which solely identify genetic material from tumours.

Dr James Larkin, researcher on the study from the University of Oxford, said: “Cancer cells have unique metabolomic fingerprints due to their different metabolic processes. We are only now starting to understand how metabolites produced by tumours can be used as biomarkers to accurately detect cancer.

“We have already demonstrated that this technology can successfully identify if patients with multiple sclerosis are progressing to the later stages of disease, even before trained clinicians could tell. It is very exciting that the same technology is now showing promise in other diseases, like cancer.”

Cancers detected earlier more likely to be treated successfully

Different people have different profiles of blood metabolites, such as healthy individuals, people with localised cancer, and people with metastatic cancer. These can be detected by the blood test and then analysed by algorithm to distinguish between these conditions.

The test helps an earlier detection of cancer, especially in patients that present with non-specific symptoms, which do not direct investigations towards a specific organ. NHS Rapid Diagnostic Centres are currently being set up across the NHS to support faster and earlier cancer diagnosis in all patients with symptoms that could indicate cancer.

This new test is not specific to a single cancer type and has shown promise in this traditionally challenging clinical context, with the potential to detect some cancers in patients before conventional imaging is performed.

Dr Fay Probert, lead researcher of the study from the University of Oxford, added: “This work describes a new way of identifying cancer. The goal is to produce a test for cancer that any GP can request.

“We envisage that metabolomic analysis of the blood will allow accurate, timely and cost-effective triaging of patients with suspected cancer, and could allow better prioritisation of patients based on the additional early information this test provides on their disease.”

This research will be continued with future studies with larger patient cohorts to further assess this technique for the earlier detection of new cancers and potential clinical applications.