At-home cell-free DNA liquid biopsy in people eligible for lung cancer screening
Description: Lung cancer is by far the leading cause of death. People at high risk for lung cancer based on smoking history are eligible for lung cancer screening (LCS) with low dose computed tomography (LDCT) so that lung cancers can be detected early when they can be cured. LDCT significantly reduces death from lung cancer but is severely underutilized due to a variety of barriers. A recent study estimated that only 4.4% of people in the US who were eligible for LCS underwent LDCT for lung screening. Minoritized and underserved communities may have additional barriers to access high-quality screening. Other health system and physician-level barriers to LCS also exist. Interventions to increase LCS utilization are urgently needed. Liquid biopsy (LB) is a blood test that can detect tiny amounts of genetic material from cancers in the blood stream. LB technology is rapidly improving in accuracy. Given the many barriers to LCS with LDCT, at-home LB may help reduce death from lung cancer in people who for one reason or another do not undergo screening for lung cancer. In this study, we are using a LB test called Delfi that we are offering to people who are eligible for LCS. The test can be done at home, and if the test is negative, lung cancer is very unlikely. We want to determine if LB testing at home is an appealing option to some people who are eligible to undergo LCS, but who face barriers to following through with LDCT or do not wish to undergo LDCT at this time. Our long-term objective is to improve early detection of lung cancer in minoritized and under-resourced communities through at-home LB testing. We plan to enroll 100 people eligible for LCS at two sites: ParkTree Community Clinic, an urban Federally Qualified Health Center (FQHC) in Los Angeles, and through the City of Hope LCS program at Antelope Valley, which services a large rural community and underserved community. We will give participants the option of an at-home LB test using Delfi, or standard LDCT. We will ask participants to complete surveys to better understand the factors that may influence their decision to have one test or the other. These include perceived barriers to LCS, sociodemographics, social determinants of health, and utilization of other cancer screening tests We will then contact participants in 6 months to see if they followed through with LDCT or were diagnosed with lung cancer, and to better understand their experience with in-home LB. Our objectives are to determine the acceptability of this approach, what factors affect the choice to undergo at-home LB, and how a positive or negative LB test affects whether people who have LB testing go on to undergo LDCT.
Funder: American Cancer Society
Amount: $300,000
Funding type: award
Start date: 2024-01-01
End date: 2025-12-31
Investigator: Dan Raz
Institution: Beckman Research Institute of the City of Hope
Funded outputs count: 0
Funder award ID: AHEAD-DBG-23-1141615-01-CPSH
OpenAlex ID: G137545457