Insight

Miguel Bronchud: What is the ideal cancer treatment?

Miguel Bronchud/bellmuntoncologia.com

Jan 21, 2025, 16:13

Miguel Bronchud: What is the ideal cancer treatment?

Miguel Bronchud, Co-Founder and Advisory Board at Regenerative Medicine Solutions, shared a post on LinkedIn about a recent paper by Jon Emery published in the Lancet Oncology:

“The ideal cancer treatment is ‘effective prevention’, or a combination of ‘early detection and long term effective immune control’?

Multicancer detection (MCD) (1) tests use a single, easily obtainable biospecimen, such as blood, to screen for more than one cancer concurrently. MCD tests, as recently reviewed in The Lancet, can potentially be used to improve early cancer detection, including cancers that currently lack effective screening methods. However, these tests have unknown and unquantified benefits and harms.

MCD tests differ from conventional cancer screening tests in that the organ responsible for a positive test is unknown, and a broad diagnostic workup may be necessary to confirm the location and type of underlying cancer.

Among two prospective studies involving greater than 16,000 individuals, MCD tests identified those who had some cancers without currently recommended screening tests, including pancreas, ovary, liver, uterus, small intestine, oropharyngeal, bone, thyroid, and hematologic malignancies, at early stages.

Reported MCD test sensitivities range from 27% to 95% (huge range difference), but differ by organ and are lower for early stage cancers, for which treatment toxicity would be lowest and the potential for cure might be highest.

False reassurance from a negative MCD result may (some authors claim) potentially reduce screening adherence, risking a loss in proven public health benefits from standard-of-care screening.

As usual, Jon Emery from Melbourne, Australia, warns us ‘prospective clinical trials are needed to address uncertainties about MCD accuracy to detect different cancers in asymptomatic individuals, whether these tests can detect cancer sufficiently early for effective treatment and mortality reduction, the degree to which these tests may contribute to cancer overdiagnosis and overtreatment, whether MCD tests work equally well across all populations, and the appropriate diagnostic evaluation and follow-up for patients with a positive test.’ ”