A spectroscopic liquid biopsy for the earlier detection of multiple cancer types

Abstract

A rapid, low-cost blood test that can be applied to reliably detect multiple different cancer types would be transformational. In this large-scale discovery study (n = 2092 patients) we applied the Dxcover® Cancer Liquid Biopsy to examine 8 different cancers. The test uses Fourier transform infrared (FTIR) spectroscopy and machine learning algorithms to detect cancer. Area under the receiver operating characteristic curve (ROC) values were calculated for 8 cancer types v symptomatic non-cancer controls: brain (0.90), breast (0.76), colorectal (0.91), kidney (0.91), lung (0.91), ovarian (0.86), pancreatic (0.84) and prostate (0.86). We assessed the test performance when all 8 cancer types were pooled to classify ‘any cancer’ against non-cancer patients. The cancer v asymptomatic non-cancer classification detected 64% of stage I cancers when specificity was 99% (overall sensitivity 57%). When tuned for higher sensitivity, this model identified 99% of stage I cancers (with specificity 59%). This spectroscopic blood test can effectively detect early-stage disease and can be fine-tuned to maximize either sensitivity or specificity depending on the requirements from different healthcare systems and cancer diagnostic pathways. This low-cost strategy could facilitate the requisite earlier diagnosis, when cancer treatment can be more effective, or less toxic.