A promising picture for multi-cancer early detection in Southeast Asia - latest update from biotech firm Gene Solutions

HO CHI MINH CITY,Vietnam,March 1,2023 -- In January 2023, Vietnam's Medical Genetics Institute & Gene Solutionspublished their research paper on Cancer Investigation: Clinical validation of a ctDNA-based assay for multi-cancer detection: an interim report from a Vietnamese longitudinal prospective cohort study of 2,795 participants.(*)

Circulating tumor DNA,or cell-free tumor DNA (ctDNA) assay is based on detecting the appearance of ctDNA in blood. This method is sometimes called Liquid Biopsy as it only requires blood sample collection,rather than tumor tissues. Theoretically,all cells release their cell-free DNA in the blood stream,including tumor cells. The characterization and sequencing ability to detect these ctDNA have been applied into multiple purposes includingprofiling tumor mutations,monitoring treatment responses,especially early cancer detection for asymptomatic individuals.

Image 1. Illustration of cell-free DNA in the blood stream (Shutterstock)

There are several assays of liquid-biopsy-based early cancer screening worldwide. However,each uses different signatures on ctDNA. Overall,these tests can simultaneously detect multiple cancer types (from 8 to 50),showing specificity above 95% while sensitivity varies from 44% to 98% depending on cancer types and disease stages.However,none of these studies wasdesigned for Southeast Asia landscape.

Foundedin Vietnam,Gene Solutions developed a multimodal liquid biopsy based assay named Screening for the Presence Of Tumor by Methylation And Size (SPOT-MAS) to detect the five most common cancer types (liver,breast,colorectal,gastric,and lung cancer).

In April 2022,the first analytical validationofSPOT-MAS testwas conducted on a cohort of 285 patients and 222 healthy individuals. This proved SPOT-MAS' ability todetect cancer patients with a sensitivity of 73.9% and a specificity of 95.9%. (**)

Later,a second clinical validation study was conducted to assess the feasibility and performance of SPOT-MAS in a multi-center clinical trial setting. Gene Solutions launched a prospective cohort study named K-DETEK at 13 major hospitals and one research institute in Vietnam.

Image 2. Discussion on testing results (Gene Solutions)

The interim analysis of 2,795 eligible asymptomatic participants (6 months from initiation)showed the feasibility of SPOT-MAS fortesting samples collected from multiple clinical sites and proved its ability to detect cancer in healthy participants at early stages. The reportdetected13 cases (0.47%) with ctDNA signal and demonstratesa positive predictive value of 60%,with 83.3% accuracy in detecting tumor location.

The researchers also presented a notablecase report to support further using SPOT-MAS as a complementary method to detectcancer andprovide the opportunity for early treatment.The patient had no warning symptoms of cancer,no history of cancer,and no family history related to cancer. He voluntarily joinedthe study in June 2022 and tookthe SPOT-MAS test. One month later,his report showed that "ctDNA signalis detected," predicting the possibility of ctDNA from liver cancer (75%) and/or colorectal cancer (23%). Hewas immediately informed and underwent diagnostic tests for liver cancer within a month. The ultrasound revealed a tumoratthe lower segment of the liver,suggesting Stage IB hepatocellular carcinoma (HCC). After these results were carefully reviewed and discussed,the patient was transferred to an oncologist for minimally invasive treatment by a combination of TACE and RFA,a non-surgical optimized method with good efficacy and safety suitable only for patients with early-stage tumors. After receiving treatment,he was scheduled for a follow-up at 12 months from the study baseline.

The performance of SPOT-MAS demonstrated in this study enables the research group to be optimistic that within the next 5 years,SPOT-MAS will be available in clinical practices and implemented in screening programs across multiple nations – alongside other routine screening tests.

Image 3. EMQN,ISO 15189:2012 Sequencing Lab (Gene Solutions)

AsGene Solutionsis expanding to Thailand,Indonesia and the Philippines,it is expected that the firm will open more ctDNA clinical validation in each country to further demonstrate the performance of SPOT-MAS and open new personalized screening method in the fight against cancer.

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Gene Solutionsis a pioneer in ctDNA research and applications in Vietnam. Its ecology covers from obstetrics,gynecology,rare diseases to oncology. Among which,SPOT-MAS,oncoGS and K-track support doctors in detecting cancer at early stage,and selecting the most appropriate mutation for targetedtherapy.

Since its founding in 2017,Gene Solutions has made it possible to offer tests at more accessible prices to the Vietnamese mass market with over 500,000 cell-free DNA tests conducted,covering every province in the country through a national network of 2,000 hospitals and clinics,and trusted by over 2,500 doctors.

With a solid base in research and development (R&D) and distribution channels,Gene Solutions is achieving its vision: to make cell-free DNAtesting affordable to millions of people,not only in Vietnam,but also in Southeast Asia,because everyone deserves better healthcare.

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Sources:

(*) Taylor & Francis Online – Cancer Investigation

(**) Vietnam Medical Journal

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Contact:

ngoctran1@genesolutions.vn