Clinical trial NCT04241796: Assessment of the Implementation of an Investigational Multi-Cancer Early Detection Test Into Clinical Practice
Official title: The PATHFINDER Study: Assessment of the Implementation of an Investigational Multi-Cancer Early Detection Test Into Clinical Practice
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Cancer
Lead sponsor: GRAIL, Inc.
Sponsor class: INDUSTRY
First posted: 2020-01-27
Enrollment: 6662
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: SCREENING

Brief summary: PATHFINDER is a prospective, multi-center study in which approximately 6,200 participants will be enrolled. An investigational multi-cancer early detection test, developed by GRAIL, will be ordered by and results returned to a study investigator. In cases with a "signal detected" test result (with a predicted or indeterminate tissue of origin (TOO)), the diagnostic work-up will not be dictated by the protocol, but will instead be coordinated by the ordering and treating medical team at the enrolling sites based on the participant's clinical condition, recommendations by each institution's clinical practices, and in consultation with the study investigator and interdisciplinary care team, as necessary. Additionally, proposed clinical care pathways, developed based on a review of guidelines from the National Comprehensive Cancer Network (NCCN), American College of Radiology (ACR) and other professional organizations, should be referenced by the medical team to determine the diagnostic work-up. The number and types of diagnostic procedures required to achieve diagnostic resolution will be assessed. Performance of multi-cancer early detection test will be evaluated. Additionally, participant-reported outcomes will be collected at several time points to assess participants' perceptions about the multi-cancer early detection test. Participants will be followed for approximately 12 months from the time of enrollment. Cancer status will also be assessed at the 12 month time point.


Eligibility criteria: Inclusion Criteria:

Cohort A: Elevated Risk Group (70% of cohort):

* Age: Participant must be 50 years of age or older at the time of signing the Informed Consent Form (ICF).
* Participants must meet at least one of the criteria below:
* History of smoking at least 100 cigarettes in his or her lifetime
* Documented genetic cancer predisposition, hereditary cancer syndrome, or meeting criteria for germline testing based on current NCCN guidelines
* Personal history of invasive or hematologic malignancy, with definitive treatment completed greater than 3 years prior to enrollment. Adjuvant hormone therapy for cancer is permissible (ie may be ongoing within 3 years or at the time of enrollment).

Cohort B: Non-Elevated Risk Group (30% of cohort):

* Age: Participant must be 50 years of age or older, at the time of signing the Informed Consent Form (ICF).
* None of the conditions described in Cohort A, criteria 2a-c
* For all participants, capable of giving signed and legally effective informed consent

Exclusion Criteria:

* Undergoing or referred for diagnostic evaluation due to clinical suspicion for cancer (e.g., referred to a medical or surgical oncologist, or scheduled for biopsy on the basis of a suspicious imaging abnormality).
* Personal history of invasive or hematologic malignancy, diagnosed within the 3 years prior to expected enrollment date, or diagnosed greater than 3 years prior to expected enrollment date and never treated.
* Definitive treatment for invasive or hematologic malignancy within the 3 years prior to expected enrollment date. Adjuvant hormone therapy for cancer is not an exclusion criterion.
* Individuals who will not be able to comply with the protocol procedures.
* Individuals who are not current patients at a participating center.
* Previous or current participation in another GRAIL-sponsored study.
* Previous or current employees or contractors of GRAIL.

Primary outcomes:
measure: Per participant count of the number and types of diagnostic tests required to achieve diagnostic resolution following a "signal detected" multi-cancer early detection test result.
timeFrame: Until diagnostic resolution or 12 months, whichever occurs first
measure: Per participant time required to achieve diagnostic resolution following a "signal detected" multi-cancer early detection test result.
timeFrame: Until diagnostic resolution or 12 months, whichever occurs first
Secondary outcomes:
measure: Positive Predictive Value defined as the proportion of participants with cancer diagnosis out of all participants with "signal detected" multi-cancer early detection test result.
timeFrame: Up to 12 months
measure: Negative Predictive Value defined as the proportion of participants with no cancer diagnosis out of all participants with "signal not detected" results and completed EOS assessment.
timeFrame: Up to 12 months
measure: Specificity defined as the proportion of participants with "signal not detected" results out of all participants with no cancer diagnosis and completed end of study (EOS) assessment.
timeFrame: Up to 12 months
measure: Tissue of origin (TOO) accuracy defined as the proportion of correct TOO predictions in participants with determinate TOO returned by the multi-cancer early detection test and cancer diagnosis.
timeFrame: Up to 12 months
measure: Perceptions of the multi-cancer early detection test result assessed by Adapted Multidimensional Impact of Cancer Risk Assessment (Adapted MICRA). Higher scores represent worse outcomes from 0-95.
timeFrame: Up to 12 months
measure: Changes in health-related quality of life following the multi-cancer early detection test assessed by Short Form Health Survey (SF-12v2).
timeFrame: Up to 12 months
measure: Changes in anxiety following the multi-cancer early detection test result: Patient-reported Outcome Measurement Information System (PROMIS) Anxiety.
timeFrame: Up to 12 months
measure: Satisfaction with the multi-cancer early detection test: scores
timeFrame: Up to 12 months
Other outcomes:
Locations:
city: Roseville
country: United States
facility: Sutter Health
state: California
city: Pensacola
country: United States
facility: Woodlands Medical Specialists, PA
state: Florida
city: Boston
country: United States
facility: Dana-Farber Cancer Institute
state: Massachusetts
city: Rochester
country: United States
facility: Mayo Clinic Rochester
state: Minnesota
city: Cleveland
country: United States
facility: Cleveland Clinic
state: Ohio
city: Eugene
country: United States
facility: Willamette Valley Cancer Institute
state: Oregon
city: Portland
country: United States
facility: Oregon Health & Science University
state: Oregon
city: Amarillo
country: United States
facility: Texas Oncology, PA (West TXO)
state: Texas
city: Saint George
country: United States
facility: Intermountain Healthcare Research
state: Utah
city: Fairfax
country: United States
facility: Virginia Cancer Specialists, PC
state: Virginia
city: Vancouver
country: United States
facility: Northwest Cancer Specialists, P.C. dba Compass Oncology
state: Washington
Study officials:
References: