Assessment of the Implementation of an Investigational Multi-Cancer Early Detection Test Into Clinical Practice

GRAIL, Inc.6,662 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

Purpose

SCREENING

Masking

NONE

Enrollment

6,662

Conditions

Cancer

Eligibility

Sex: ALLMin age: 50 YearsHealthy volunteers:

Medical Language ↔ Plain English

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.

Locations (11)

Sutter Health

Roseville, California, United States

Woodlands Medical Specialists, PA

Pensacola, Florida, United States

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Mayo Clinic Rochester

Rochester, Minnesota, United States

Cleveland Clinic

Cleveland, Ohio, United States

Willamette Valley Cancer Institute

Eugene, Oregon, United States

Oregon Health & Science University

Portland, Oregon, United States

Texas Oncology, PA (West TXO)

Amarillo, Texas, United States

Intermountain Healthcare Research

St. George, Utah, United States

Virginia Cancer Specialists, PC

Fairfax, Virginia, United States

...and 1 more locations

Outcomes

Primary Outcomes

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.

Time frame: Until diagnostic resolution or 12 months, whichever occurs first

Per participant time required to achieve diagnostic resolution following a "signal detected" multi-cancer early detection test result.

Time frame: Until diagnostic resolution or 12 months, whichever occurs first

Secondary Outcomes

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.

Time frame: Up to 12 months

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.

Time frame: Up to 12 months

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.

Time frame: Up to 12 months

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.

Time frame: Up to 12 months

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.

Time frame: Up to 12 months

Changes in health-related quality of life following the multi-cancer early detection test assessed by Short Form Health Survey (SF-12v2).

The SF-12v2 is a measure of health related quality of life. Higher values represent better health e.g. Physical Component Summary (PCS) range from 4.62 to 76.36 and Mental Component Summary (MCS) range from 1.32 to 79.48.

Time frame: Up to 12 months

Changes in anxiety following the multi-cancer early detection test result: Patient-reported Outcome Measurement Information System (PROMIS) Anxiety.

Assessed by Patient-reported Outcome Measurement Information System (PROMIS) Anxiety. Range in score from 4 to 20 with higher scores indicate greater severity of anxiety.

Time frame: Up to 12 months

Satisfaction with the multi-cancer early detection test: scores

Range in score from 0-100 with higher scores indicating higher satisfaction.

Time frame: Up to 12 months

Assessment of the Implementation of an Investigational Multi-Cancer Early Detection Test Into Clinical Practice

Overview

Conditions

Interventions

Eligibility

Locations (11)

Outcomes

Primary Outcomes

Secondary Outcomes