← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Advancing Multi-Cancer Early Detection to Save Lives with Exact Sciences
00:15:43
Loading summary
Transcript15 lines
- [00:00]
A
Hi everyone, this is Lucas Vaz with Beckers Healthcare. Thanks so much for tuning in to the Beckers Healthcare podcast series. It's fantastic to have you. We're going to talk about what health systems need to know about multicancer early detection today. And I'm very excited to be joined by Dr. Tom Baer, Chief medical officer for multicancer early detection at exact Sciences Corporation. Dr. Baer, thanks so much for being here today. It's great to have you, Lukas, it's.
- [00:29]
B
Really great to be with you today.
- [00:30]
A
Thank you so much for taking some time. Hey, for our audience, could you just introduce yourself and just share a little bit about your background and your work in healthcare?
- [00:38]
B
Sure. So, first and foremost, I'm a medical oncologist. I take care of patients with prostate cancer. Still half a day a week while working for Exact Sciences and prior to that was an academic medical oncologist with experience running clinical trials, running a prostate cancer program, and serving as deputy director of an NCI designated comprehensive cancer center. About eight years ago, I got really interested in cancer early detection and had the opportunity to lead a center for early detection at the OHSU Knight Cancer Institute where I got a chance to collaborate with Exact Sciences and many other organizations developing novel cancer screening tests. And about three years ago, I got the call from Exact Sciences to see if I wanted to join and help deliver a multi cancer early detection test out of Exact Sciences laboratories to the clinic and to patients where it can have an impact. For the last three years, my primary responsibility has been to provide the medical leadership to our multi cancer early detection program here at Exact Sciences.
- [01:50]
A
It's so fantastic to have you. Thank you so much. Again, I want to start off with a couple of numbers here because I know it's, it needs to be mentioned and I know how personal and important this is to you. In 2024, we saw nearly 1700 cancer related deaths each day, with cancer remaining the second leading cause of death in the United States right now. Proactive care and screening really plays a critical in changing that and making a dent in those numbers. We're hearing a lot more about multi cancer early detection in this context. Really? But for many, I feel like it's still a new concept. Can you walk us through what multicancer early detection is and how it could transform early cancer detection?
- [02:40]
B
Absolutely. So let's start for a moment with those 1700 individuals who are dying from cancer every day. In the United States alone, 2/3 of those individuals are diagnosed with a cancer that we do not screen for. Today, we Know that earlier detection through screening saves lives. And it's really our best hope in the fight against cancer. But today, when we look at guideline recommended screening options, we really only routinely screen for four common cancers. Two thirds of cancer deaths and two thirds of cancer diagnoses Are from cancer types that we essentially just allow to sneak up on us. We don't look for them proactively, and we only diagnose them when they become clinically apparent. Multi cancer early detection is all about changing that reality. What multi cancer early detection strives to do Is develop blood based cancer screening tests designed to detect many different cancers simultaneously in a single blood test to dramatically expand the reach of cancer screening from those four cancers we just talked about to the large majority of cancers that were at risk for when we succeed in delivering multicancer early detection to the public, I expect a dramatic shift in how cancers are diagnosed and how cancers are treated as we shift diagnosis from later stages into earlier stages of disease, where treatments can be more effective, Less costly, and cause fewer side effects. That's the concept. That concept is being delivered through blood tests, which measure different biomarker classes. And these biomarkers are substances secreted by cancer cells into the bloodstream. Many of them are shared by a variety of different cancer types, which is what enables us to contemplate a single blood test for many different cancers.
- [04:53]
A
And really, that proactivity is so fascinating because, again, like you've said, it will hopefully help us to be more proactive in that screening process and help more people. Now, you've been really driving this convers and having more conversations on this before, and you've recently been engaging with health system leaders to better understand their perspectives on multicancer early detection. Can you share why you felt it was important to launch a survey? The survey to be able to talk to health system leaders. What do you hope to learn from some of the results that you might be getting? And how will those insights help drive adoption moving forward?
- [05:35]
B
This is a completely new paradigm in cancer screening. We really want to understand how health system leaders view this opportunity today. What excites them the most about engaging with multicancer early detection? What barriers they see for adoption and implementation, what questions they have that we and others may need to answer to prepare them better for implementation of this new class of cancer screening tests. We're deeply engaged in asking those questions and really look forward to learning what health system leaders are thinking about this opportunity and how we can help make it a reality.
- [06:23]
A
Yeah, I think this learning portion is so critical because again, it needs to be applied to be able to help people and then to be able to proactively. As we've mentioned at the beginning of our conversation, clinical leadership is really essential in how these innovations are understood and ultimately adopted. I feel like. From your perspective, what does thoughtful clinically led implementation of multicancer early detection look like and what are some guidance that you would offer to health systems as they're starting to explore the space?
- [06:56]
B
Sure. So I would think about it in terms of three distinct areas. One is selecting the test for implementation and some of the features and considerations that might go into that. A second and related part is a whole host of implementation issues that might drive towards implementation success. And then thinking about thinking ahead to outcome tracking and really understanding post implementation how MSET testing is impacting on the population of patients that a particular health system serves. So if we start with test selection, one of the unique features of the Exact Sciences test is that we have constructed it on a multi biomarker class platform. We're looking at analysis of circulating DNA specifically for DNA methylation and also for tumor associated proteins in the bloodstream. We believe that that approach gives us more shots on goal to detect cancers and that these two biomarker classes can be complementary, meaning that sometimes we can detect a cancer through one or the other, but not both. And so that using both gives us the potential for better test performance. We've also really focused on maximizing the early stage sensitivity of these multi cancer early detection tests that we're developing. Detecting cancer at earliest possible stages, and particularly stage one and stage two gives us the greatest opportunity to offer a patient treatment with curative intent and long term good outcomes. Looking at that ability of these tests to detect a broad range of cancers at the earliest possible stages is a key feature. A third feature to consider I think for a health system and a clinical leadership. And this bleeds into implementation, but it's also related to the test design is how is a test result followed up with a diagnostic journey for the patient? How do we get the patient the definitive answer about whether a cancer is present or not? Like all screening tests, our test, Cancer Guard and other MSAID tests in this class are not diagnostic tests, they're screening tests and they deliver a signal that either gives us reassurance that no evidence of cancer was found or that a cancer signal is present. And another additional diagnostic tests need to be conducted to rule in or rule out the presence of cancer. In the case of our test, we have really focused on a streamlined, reproducible diagnostic Pathway that is very clear to clinicians, begins with a routine clinic visit and then deploys a structured pathway through imaging to get to a definitive answer. We've got a solid scientific basis for that approach and we believe clinicians will find this approach straightforward to implement and trustworthy. So those are some of the considerations somebody might take a look at when considering which test to implement. Beyond the test selection, the approach to implementation, I think needs to include a robust plan for provider education. This is truly a new class of tests. It is distinct from single cancer screening. It is unfamiliar to many clinicians and still some health systems really being proactive about building understanding of what these tests can and can't do. Why it's so important, for example, that patients don't skip their proven standard of care single cancer screening tests as they engage with multicancer early detection. Really understanding the role of the test and then the execution of the evaluation pathway that follows a test is critically important for a successful implementation. Then integration into the electronic medical record, enabling easy ordering and reliable, robust return of results to clinicians. So that's an obvious feature to consider, but other support that might be available with the test. In our case, for example, an Exact sciences navigation team routinely reaches out to providers when there is a positive test result to ensure that they have the information they need to guide the patient through their diagnostic evaluation. Patients have access to third party navigation to assist them in making the necessary appointments should they need that sort of assistance. So it's not just about a test, it's about how it's delivered to the clinic and what the patient experience is like. And finally, I think thinking ahead to tracking health system and patient outcomes with implementation of this class of tests is really something to consider. Understanding what implementation does for the distribution of cancer diagnoses in a health system over time, looking for the expected shift towards earlier stage diagnoses and the impact of that not just on utilization of imaging, but potentially on utilization of therapies with curative intent like surgery or radiation across a population of cancer patients. And then of course, longer term outcomes in that population are important. So that's, that's a lot of ground to cover. But it's an exciting new area and I really wanted to touch on a number of the main points.
- [13:02]
A
Yeah, I think the most important run really is, as you've mentioned earlier, more shots on goal, I think. Right. More shots that are hitting. And to keep that sports analogy up, I do feel like this is really a game changer and can be a game changer with more shots on goal. Well, Dr. Bear, again thank you so much for sharing those insights. Fantastic. I do want to give you the floor here before we close out. Is there anything else we didn't touch on or any final thoughts you'd like.
- [13:30]
B
To share with us? Yeah, well Lucas, I think one of the things that really gets me up every morning is the long term potential impact of Cancer Guard and tests like it. And we have a wonderful healthcare outcome modeling group at Exact Sciences that has enabled us to ask some questions about what might we expect if the general population adopts Cancer Guard on a routine basis. We modeled that with all of the assumptions of the current state, current health of the United States, current access to standard of care screening. Nothing really changes except the introduction of of an annual Cancer Guard test. We looked at a 10 year period of time and asked the question how would the distribution of cancers diagnosed change and what might the impact on cancer mortality be? What the modeling group arrived at is that we would expect a 42% reduction in stage 4 metastatic cancer burden across all cancer types in the population. Some corresponding increases in stage one, two and three. That large shift away from advanced disease would be projected to produce about a 17 18% reduction in all cancer mortality in the population. Now these are modeling results. We need to confirm that over time with long term follow up of patients tested with Cancer Guard. But it's these kinds of results that get me excited about working in this field every day.
- [15:23]
A
Dr. Bayer, thanks so much for your time and insights today. It's fantastic to have you. Thanks for being here.
- [15:27]
B
It's my pleasure.
- [15:29]
A
We also want to thank our podcast sponsor, Exact Sciences Corporation. You can tune into more podcasts from Beckers Healthcare by visiting our podcast page @becker's hospital review.com.