A blood test to help detect lung cancer? New test offered at OSF Healthcare is part of a trend in medicine – Chicago Tribune

Julie Harris had never been tested for lung cancer. She never found time for a low-dose CT scan, the only screening recommended for adults at risk of developing lung cancer.

But when her primary care doctor recently suggested a new blood test to help detect signs of the disease, Harris was intrigued. She had her blood drawn the same day, in the same building as her doctor’s appointment.

“It was something that was accessible at the moment, so it was like, ‘Sure, let’s go ahead and do this and see what the results are,'” said Harris, 67, of Beijing. Harris, a long-time smoker, said if the results come back positive, she will undergo a low-dose CT scan in addition to screening for the disease.

“Science continues to advance,” she said.

Harris is among the first group of patients in Illinois to get the blood test as part of a pilot program by the OSF HealthCare health system, which offers the test at 18 sites. OSF leaders hope the blood tests will improve early detection of lung cancer, which kills more people in the United States than any other type of cancer.

OSF’s adoption of the blood test is part of a growing movement in medicine to use less invasive screenings to look for signs of cancer in patients, particularly those who may be reluctant to undergo more traditional and complex tests . A number of blood tests to detect various types of cancer are currently in development, according to the University of Texas MD Anderson Cancer Center. Some health systems, like OSF, are beginning to offer blood tests to patients, while others are waiting with cautious optimism for longer-term data on the tests.

“This is the future,” Dr. Jared Meeker, a pulmonologist at OSF, said of the new blood test.

The blood test used at OSF is not intended to replace a low-dose CT scan, which involves lying on a table that slides in and out of some type of X-ray machine.

The FirstLook Lung blood test, developed by Delfi Diagnostics, based in California and Maryland, does not diagnose lung cancer. But doctors hope that patients who don’t want to have a CT scan – perhaps because it would require too much time, travel or effort – will agree to have a blood test. If the blood test comes back positive, indicating a possibility of lung cancer, OSF leaders hope that patients will then be more likely to agree to a low-dose CT scan.

The U.S. Preventive Services Task Force recommends that people at higher risk of developing lung cancer have low-dose CT scans annually. Patients at higher risk are those aged 50 to 80 who have been moderate to heavy smokers, currently smoke, or have stopped smoking within the past 15 years. But only about 4.5% of those people actually had a low-dose CT scan in 2022, according to a report from the American Lung Association.

“If everyone eligible for a low-dose scan already had it, our test would be of no use,” said Dr. Peter Bach, chief medical officer at Delfi. “The problem we have is that’s not the case, so what we’re trying to do is accelerate the conversations between them and their doctors about low-dose CT and educate them.”

A blood collection kit used to screen for lung cancer at OSF Medical Group in Hopedale, Illinois.  (Daryl Wilson/for the Chicago Tribune)
A blood collection kit used to screen for lung cancer at OSF Medical Group in Hopedale, Illinois. (Daryl Wilson/for the Chicago Tribune)

The blood test works by looking for patterns of DNA fragments in the blood that could indicate lung cancer. If a person has lung cancer that would be detectable by a low-dose CT scan, there is an 80% chance that the blood test will come back positive, while if the blood test is negative, there is a 99.8% chance. chance that the person does not have lung cancer. cancer, Bach said.

Delfi is seeking approval for its test from the U.S. Food and Drug Administration, which in recent weeks has announced plans to more closely regulate lab-developed tests. Until now, the Centers for Medicare & Medicaid Services has primarily regulated laboratory testing. Delfi says the blood test has received a breakthrough designation from the FDA, a designation intended to help expedite the development, review and evaluation of certain devices and products.

The blood test is not covered by health insurance and Delfi declined to give a price. OSF executives say they are still working on price, but aim to make the test as accessible to patients as possible. Neither OSF nor Delfi would say whether patients currently receiving the test at OSF are being charged. Low-dose CT scans are covered by health insurance.

Blood tests performed by other companies to help detect cancers have list prices of around $900 to $950.

OSF doctors hope this blood test will lead to earlier detection of lung cancer patients. The five-year survival rate for people with very small tumors that have not spread to the lymph nodes is 90%, but the five-year survival rate for people with lung cancer that has spread to other organs is only 7%, according to the Cleveland Clinic.

“No one wants to diagnose stage 3 and 4 lung cancer,” Meeker said. “It’s devastating.”

Patients don’t always fully understand the implications of late diagnosis, said Dr. Tim Vega, OSF’s chief population health officer.

“People think, ‘I smoke, if I figure it out, I’ll check it out real quick,'” Vega said. “They don’t realize that these could be difficult years for them and their families. »

At OSF, about 33 percent of eligible patients already receive low-dose CT scans — much better than national figures — but still not as high as doctors would like, Vega said.

OSF executives are looking to Cologuard’s success as a model for how the new blood test could help patients. The U.S. Food and Drug Administration approved Cologuard about 10 years ago as a home screening test for colon cancer. Patients send a stool sample to a lab, which then analyzes it – a much quicker and less invasive task for patients than undergoing a colonoscopy.

As with the Delfi blood test, a positive Cologuard result does not diagnose cancer, but does mean a person may have it and requires further testing. OSF began offering Cologuard to its patients a few years ago and found that when patients get positive test results, they almost always agree to have a colonoscopy next, Vega said.

OSF isn’t the only healthcare provider with high hopes for the blood test.

The White House recently noted in an announcement regarding President Joe Biden’s Cancer Moonshot that Delfi was working with the PACT Indigenous Foundation to improve lung cancer screening among Native American tribes in the Pacific Northwest. Delfi is also working with City of Hope on a clinical study, funded by the American Cancer Society, aimed at improving lung cancer screening in underserved communities in Los Angeles County.

Doctors also monitor other types of blood tests and monitor their performance. The Grail and Guardant Health companies also offer blood tests to help detect various types of cancer.

The University of Illinois Cancer Center is now participating in a clinical trial to study the Grail blood test, which detects a cancer signal shared by several cancers.

“I still think we have a long way to go to understand how these types of tests fit into the broader context of cancer prevention and screening, but it’s very exciting,” said Dr. Ameen Salahudeen, assistant professor of medicine at the University of Illinois. in Chicago, a member of the IU Cancer Center and an investigator in the Grail-sponsored trial. “I never want to see anyone with advanced cancer that could have been detected earlier, so personally I believe tests like these will play a role in the future.”

Dr. Rajat Thawani, an assistant professor of medicine at the University of Chicago and a thoracic oncologist, said such blood tests are promising, but before they are widely adopted, longer-term data are likely needed. to find out if the tests can help lead to better quality and length of life for patients.

“There’s a lot of excitement about the usefulness of how this is going to play out going forward, but I think right now we need to make sure that this actually leads to meaningful change in longevity of patients,” Thawani said.

If the Delfi blood test makes a difference at OSF, leaders hope to offer it to the entire health system within a year, said Ryan Luginbuhl, OSF service line vice president for oncology services. . OSF HealthCare has nearly 160 locations, including 16 hospitals, across Illinois and Michigan. Most of its locations are in central and northern Illinois, and the system includes OSF Little Company of Mary Medical Center in Evergreen Park as well as primary care, office and urgent care centers in the Chicago area.

“We will do everything we can when we hope it proves effective … to make this available to as many patients as possible,” Luginbuhl said.