Last week, the NHS launched the world’s largest trial of a revolutionary new blood test that can detect more than 50 types of cancer before symptoms appear. The first people to take part will have blood samples taken at mobile testing clinics in retail parks and other convenient community locations. The Galleri™ test checks for the earliest signs of cancer in the blood and the NHS-Galleri trial, the first of its kind, aims to recruit 140,000 volunteers in eight areas of England to see how well the test works in the NHS.
What is the test?
The test is a simple blood test that research has shown is particularly effective at finding cancers that are typically difficult to identify early – such as head and neck, bowel, lung, pancreatic, and throat cancers. It works by finding chemical changes in fragments of genetic code – cell-free DNA (cfDNA) – that leak from tumours into the bloodstream. The NHS is already sending out letters inviting tens of thousands of people from different backgrounds and ethnicities aged between 50 and 77 to take part.
Participants, who must not have had a cancer diagnosis in the last three years, will be asked to give a blood sample at a locally based mobile clinic and they will then be invited back after 12 months, and again at two years, to give further samples. The trial is part of the NHS’s efforts to increase the proportion of cancers detected early by the end of the Long Term Plan.
Partnership
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 that span Cheshire and Merseyside, Cumbria, Greater Manchester, the North East, West Midlands, East Midlands, East of England, Kent and Medway, and South East London. For the purposes of the trial, only people living in these areas will be invited.
Initial results of the study are expected by 2023 and, if successful, the NHS in England plans to extend the rollout to a further one million people in 2024 and 2025. Patients whose cancer is found early – known as stage one or two – typically have a broader range of treatment options available to them, which can be curative and are often less aggressive.
A patient whose cancer is diagnosed at the earliest stage typically has between five and 10 times the chance of surviving compared with those found at ‘stage four.’
GRAIL is a healthcare company whose mission is to detect cancer early when it can be cured. GRAIL is focused on saving lives and improving health by pioneering new technologies for early cancer detection. The company is using the power of next-generation sequencing, population-scale clinical studies, and state-of-the-art computer science and data science to overcome one of medicine’s greatest challenges with Galleri™, GRAIL’s multi-cancer early detection blood test. With this proprietary technology, GRAIL is also developing solutions to help accelerate cancer diagnoses, blood-based detection for minimal residual disease, and other post-diagnostic applications.
NHS Long Term Plan
Sir Harpal Kumar, President of GRAIL Europe, encourages the Asian communities in England to come forward to participate. Speaking exclusively to Asian Voice, Sir Harpal Kumar said, “Our goal is to recruit participants from a wide range of backgrounds, ensuring the results are relevant for as many different people as possible. The Galleri blood test, if successful, could play a major part in achieving the NHS Long Term Plan ambition to catch three-quarters of cancers at an early stage, when they are easier to treat. So if you are invited, please take part - you could be helping the NHS to revolutionise cancer care and protect yourself.”
All participant information sheets are available in Gujarati, Bengali, Punjabi and Urdu and translators are available to volunteers on request.
“This is a trial operating in 8 regions of the UK (see release). Mobile clinics will move to different accessible locations in each region such as supermarket car parks,” Sir Kumar told the newsweekly.
NHS will make the decision
Explaining the kind of support - monetary and regulatory, that he would need from the government to take this forward and make this a success, Sir Harpal told us, “The potential future use of Galleri in the NHS is partly what this trial will help determine - we have a comprehensive health economic programme underway with this trial. Ultimately, it will be for NHS England to make this decision based on the results of the trial. Alongside the health benefit to those who get cancer, we believe that multi-cancer early detection (MCED) will save lives and reduce the economic burden of cancer - firstly because it allows us to detect many more cancers early without adding the significant costs (from diagnostic testing) associated with false positives; and secondly because treating cancer in later stages, or when it has spread to other parts of the body, is far more costly than treatments for early-stage cancer.”
“The third and final sub-study of the Circulating Cell-free Genome Atlas (CCGA) study found that Galleri detected cancer signals from more than 50 different types of cancer. These include cancers which account for around two-thirds of cancer deaths in the UK - Anal, bladder, bowel, oesophageal, stomach, head and neck, liver and bile duct, lung, ovarian and pancreatic cancers, lymphoma and cancers of the plasma cells, such as multiple myeloma,” Sir Harpal told Asian Voice.
Sir Harpal Kumar said: “We’re delighted to partner with the NHS to support the NHS Long Term Plan for earlier cancer diagnosis, and we are eager to bring our technology to people in the UK as quickly as we can. The Galleri test can not only detect a wide range of cancer types but can also predict where the cancer is in the body with a high degree of accuracy. The test is particularly strong at detecting deadly cancers and has a very low rate of false positives.”
Advantages of the test
Talking about the advantages of this test, he said, “We believe that multi-cancer early detection (MCED) will save lives and reduce the economic burden of cancer - firstly because it allows us to detect many more cancers early without adding the significant costs associated with false positives; and secondly because treating cancer in later stages, or when it has spread to other parts of the body, is far more costly than treatments for early-stage cancer.”
As part of the trial design, only those people whose test detects potential signals of cancer in their blood will be contacted and referred for diagnostic tests in the NHS. Everyone who gives a blood sample as part of the NHS-Galleri trial should receive a letter around 30 days after their appointment to confirm that their sample has been received.
Will this test may also reduce the load on the pathology labs at NHS, which otherwise carry rigorous tests, which are more expensive and tedious to detect diseases like cancer? Sir Harpal said, “The potential future use of Galleri in the NHS is partly what this trial will help determine - we have a comprehensive health economic programme underway with this trial. Ultimately, it will be for NHS England to make this decision based on the results of the trial.”
