In July NHS chief executive Amanda Pritchard announced the latest milestone in NHS cancer innovation with an update on the NHS-Galleri trial (the blood test that potentially offers earlier detection of hard to spot cancers, even before symptoms appear).
Over 140,000 people have taken part in the world’s largest trial of a blood test that can detect more than 50 types of cancer, as part of the latest NHS drive to catch the disease when it is generally easiest to treat.
“It has been estimated that cancer detection before stage IV could reduce cancer-related deaths by 15% within 5 years. A new approach called multi-cancer early detection (MCED) has the potential to achieve this goal by detecting signals for multiple cancers from cell-free DNA (cfDNA) or other circulating analytes in the blood, shed by tumors.
The introduction of MCED tests, such as the Galleri (TM) test, together with current screening protocols may promote early detection, enabling better outcomes.” Klein et al (2021)
“Cell-free DNA (cfDNA) is released from cells into the circulatory system throughout the body. It was first discovered by Mandel and Métais in 1948 . It can be found in plasma and other body fluids. However, in certain conditions, such as pregnancy, organ transplantation, and cancers, the related/affected tissues could release additional DNA into peripheral circulation. Therefore, detection of cfDNA in peripheral blood could identify abnormalities of individuals.” Yan et al (2021)
In just one year since the NHS-Galleri trial began, volunteers from across the country have taken up the invitation to have a blood test at mobile clinics in over 150 convenient locations, including supermarket and leisure centre car parks and places of worship. GPs were vital in the recruitment process.
Participants will now be invited to attend two further appointments, spaced roughly 12 months apart.
The NHS Long Term Plan committed to increasing the proportion of cancers caught early, when they are easier to treat, from half to three in four. This trial is part of radical NHS action to tackle cancer, that also includes high street pharmacies spotting signs of cancer and sending people for checks, drones delivering chemotherapy, and roaming lung and liver scanning trucks going into communities.
Initial research has shown that this blood test could help to detect cancers that are typically difficult to identify early – such as head and neck, bowel, lung and pancreatic cancers.
“The NHS will not stand still in our efforts to catch cancer earlier and save more lives, rolling out new and innovative ways to detect cancers sooner; from roaming liver trucks, to genetic testing and high street checks, we want to make it as easy as possible for those most at risk to get vital, lifesaving tests.
“This marks an important milestone in our long-term efforts to catch and treat cancer earlier – we know that certain cancers are harder to detect and a late diagnosis can be devastating for patients and their families, and this trial means thousands could benefit from a diagnosis even before symptoms appear.”
NHS chief executive Amanda Pritchard
While it is too early to report on the results of the trial, a number of participants have been referred for urgent NHS cancer investigations following the detection of a cancer signal.Those joining the trial were aged of 50 to 77 years old and did not have signs of cancer at the time of enrolment.
The test works by finding chemical changes in fragments of DNA (cfDNA) that shed from tumours into the bloodstream.
Mobile clinics will return to towns and cities from September this year and will follow up with volunteers approximately one year after their initial appointment.
If successful, the NHS in England plans to roll out the test to a further one million people across 2024 and 2025.
“We are so grateful for the public’s enthusiasm for this trial and to all those who have volunteered and are looking forward to participants coming back to our mobile clinics from September.
“Previous research has shown that the test is particularly strong at detecting deadly cancers and our hope is that it will help the NHS to reduce the number of cancers detected at a late stage. . . “
Sir Harpal Kumar, President of GRAIL Europe
The NHS-Galleri trial is being run by The Cancer Research UK
and King’s College London Cancer Prevention Trials Unit in partnership with the NHS
and healthcare company, GRAIL, which has developed the Galleri test.
It is operating with the support of eight NHS Cancer Alliances across England
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