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Blood test for breast cancer may be a step closer

Researchers are developing panels of breast cancer associated tumour-associated antigens

Ingrid Torjesen

Monday, 04 November 2019

Breast cancer may eventually be able to be detected before there are any clinical signs of it, using a blood test, suggests research* presented at the 2019 National Cancer Research Institute (NCRI) Cancer Conference in Glasgow yesterday.

The body produces autoantibodies against cancer cell antigens. Now researchers at the University of Nottingham have developed panels of tumour-associated antigens (TAAs) that are known to be good indicators of breast cancer regardless of whether there are autoantibodies against them in a patient’s blood.

In a pilot study, the researchers took blood samples from 90 breast cancer patients at the time they were diagnosed with breast cancer and matched them with samples taken from 90 patients without breast cancer (the control group).

They used protein microarray screening technology to check for the presence of autoantibodies against 40 TAAs associated with breast cancer, and also 27 TAAs that were not known to be linked with the disease.

Ms Daniyah Alfattani, a PhD student, who is part of the Centre of Excellence for Autoimmunity in Cancer (CEAC) group at the School of Medicine, University of Nottingham, said: "The results of our study showed that breast cancer does induce autoantibodies against panels of specific tumour-associated antigens. We were able to detect cancer with reasonable accuracy by identifying these autoantibodies in the blood."

The researchers identified three panels of TAAs against which to test for autoantibodies. The accuracy of the test improved in the panels that contained more TAAs. The panel of five TAAs correctly detected breast cancer in 29% of the samples from the cancer patients and correctly identified 84% of the control samples as being cancer-free. The panel of seven TAAs correctly identified cancer in 35% of cancer samples and no cancer in 79% of control samples. The panel of nine antigens correctly identified cancer in 37% of cancer samples and no cancer in 79% of the controls.

Professor Paul Pharoah, professor of cancer epidemiology at the University of Cambridge, pointed out that the current sensitivity was “far too low”.

“Not only does it not detect cancer five years before it could be clinically diagnosed, it missed 65% of clinically diagnosed cancers,” he said. “These are clearly very preliminary data and a lot more research would be needed before any claim can be made that this is likely to represent a meaningful advance in the early detection of cancer.”

"We need to develop and further validate this test," agreed Ms Alfattani. "However, these results are encouraging and indicate that it's possible to detect a signal for early breast cancer. Once we have improved the accuracy of the test, then it opens the possibility of using a simple blood test to improve early detection of the disease."

The researchers are now testing samples from 800 patients against a panel of nine TAAs, and they expect the accuracy of the test to improve with these larger numbers.

"A blood test for early breast cancer detection would be cost effective, which would be of particular value in low and middle income countries. It would also be an easier screening method to implement compared to current methods, such as mammography," said Ms Alfattani.

Dr Iain Frame, CEO of NCRI said: "Early diagnosis using simple, non-invasive ways of detecting the first signs of cancer is a key strategic priority for NCRI and something we'd all like to see working in practice. The results from this pilot study for a blood test to detect early breast cancer are promising and build on this research group's expertise in other cancers, such as lung cancer. It's obviously early days but we look forward to seeing the results from the larger group of patients that are now being investigated."

A similar test for lung cancer is currently being tested in a randomised controlled trial in Scotland, involving 12,000 people at high risk of developing lung cancer because they smoke. Participants who test positive for the autoantibodies are then followed up with a CT scan every two years in order to detect lung cancer in its early stages when it is easier to treat.

The CEAC group is also working on similar tests for pancreatic, colorectal and liver cancers.

*Abstract no: Poster 2966. Daniyah Alfattani, et al. ‘Clinical utility of autoantibodies in early detection of breast cancer’.

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