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Article ; Online: The Promise of Multicancer Early Detection.

Klein, Eric A / Beer, Tomasz M / Seiden, Michael

2023 Volume 136, Issue 3, Page(s) e46–e47

MeSH term(s)	Humans ; Neoplasms ; Risk Factors ; Early Detection of Cancer
Language	English
Publishing date	2023-02-18
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
DOI	10.1016/j.amjmed.2022.05.016
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Article: The Promise of Multicancer Early Detection. Comment on Pons-Belda et al. Can Circulating Tumor DNA Support a Successful Screening Test for Early Cancer Detection? The Grail Paradigm.

Klein, Eric A / Beer, Tomasz M / Seiden, Michael

Diagnostics (Basel, Switzerland)

2022 Volume 12, Issue 5

Abstract: Multicancer Early Detection (MCED) represents a new and exciting paradigm for the early detection of cancer, which is the leading cause of death worldwide. Current screening tests, recommended for only five cancer types (breast, lung, colon, cervical, ... ...

Abstract	Multicancer Early Detection (MCED) represents a new and exciting paradigm for the early detection of cancer, which is the leading cause of death worldwide. Current screening tests, recommended for only five cancer types (breast, lung, colon, cervical, and prostate), are limited by a lack of complete adherence to guideline-based use and by the fact that they have cumulative high false positive rates. MCED tests agnostically detect cancer signals in the blood with good sensitivity and low false positive rates, can predict the cancer site of origin with high accuracy, can detect highly lethal cancers that have no current screening tests, and promise to improve cancer screening by improving efficiency and reducing the overall number needed to screen. Herein we outline this promise and clarify several published misconceptions about this field.
Language	English
Publishing date	2022-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics12051243
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Article ; Online: Multicancer early detection.

Klein, Eric A / Beer, Tomasz M / Seiden, Michael

Clinical chemistry and laboratory medicine

2022 Volume 60, Issue 5, Page(s) e119–e120

MeSH term(s)	Biopsy ; Early Detection of Cancer ; Humans ; Mass Screening ; Neoplasms/diagnosis
Language	English
Publishing date	2022-02-03
Publishing country	Germany
Document type	Letter ; Comment
ZDB-ID	1418007-8
ISSN	1437-4331 ; 1434-6621 ; 1437-8523
ISSN (online)	1437-4331
ISSN	1434-6621 ; 1437-8523
DOI	10.1515/cclm-2022-0058
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Article ; Online: Health State Utilities Associated with False-Positive Cancer Screening Results.

Matza, Louis S / Howell, Timothy A / Fung, Eric T / Janes, Sam M / Seiden, Michael / Hackshaw, Allan / Nadauld, Lincoln / Karn, Hayley / Chung, Karen C

PharmacoEconomics - open

2024 Volume 8, Issue 2, Page(s) 263–276

Abstract: Introduction: Early cancer detection can significantly improve patient outcomes and reduce mortality rates. Novel cancer screening approaches, including multi-cancer early detection tests, have been developed. Cost-utility analyses will be needed to ... ...

Abstract	Introduction: Early cancer detection can significantly improve patient outcomes and reduce mortality rates. Novel cancer screening approaches, including multi-cancer early detection tests, have been developed. Cost-utility analyses will be needed to examine their value, and these models require health state utilities. The purpose of this study was to estimate the disutility (i.e., decrease in health state utility) associated with false-positive cancer screening results. Methods: In composite time trade-off interviews using a 1-year time horizon, UK general population participants valued 10 health state vignettes describing cancer screening with true-negative or false-positive results. Each false-positive vignette described a common diagnostic pathway following a false-positive result suggesting lung, colorectal, breast, or pancreatic cancer. Every pathway ended with a negative result (no cancer detected). The disutility of each false positive was calculated as the difference between the true-negative and each false-positive health state, and because of the 1-year time horizon, each disutility can be interpreted as a quality-adjusted life-year decrement associated with each type of false-positive experience. Results: A total of 203 participants completed interviews (49.8% male; mean age = 42.0 years). The mean (SD) utility for the health state describing a true-negative result was 0.958 (0.065). Utilities for false-positive health states ranged from 0.847 (0.145) to 0.932 (0.059). Disutilities for false positives ranged from - 0.031 to - 0.111 (- 0.041 to - 0.111 for lung cancer; - 0.079 for colorectal cancer; - 0.031 to - 0.067 for breast cancer; - 0.048 to - 0.088 for pancreatic cancer). Conclusion: All false-positive results were associated with a disutility. Greater disutility was associated with more invasive follow-up diagnostic procedures, longer duration of uncertainty regarding the eventual diagnosis, and perceived severity of the suspected cancer type. Utility values estimated in this study would be useful for economic modeling examining the value of cancer screening procedures.
Language	English
Publishing date	2024-01-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2874287-4
ISSN	2509-4254 ; 2509-4262
ISSN (online)	2509-4254
ISSN	2509-4262
DOI	10.1007/s41669-023-00443-w
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Article ; Online: Patient Preferences for Multi-Cancer Early Detection (MCED) Screening Tests.

Gelhorn, Heather / Ross, Melissa M / Kansal, Anuraag R / Fung, Eric T / Seiden, Michael V / Krucien, Nicolas / Chung, Karen C

The patient

2022 Volume 16, Issue 1, Page(s) 43–56

Abstract: Background: Emerging blood-based multi-cancer early detection (MCED) tests can detect a variety of cancer types across stages with a range of sensitivity, specificity, and ability to predict the origin of the cancer signal. However, little is known ... ...

Abstract	Background: Emerging blood-based multi-cancer early detection (MCED) tests can detect a variety of cancer types across stages with a range of sensitivity, specificity, and ability to predict the origin of the cancer signal. However, little is known about the general US population's preferences for MCED tests. Objective: To quantify preferences for MCED tests among US adults aged 50-80 years using a discrete choice experiment (DCE). Methods: To quantify preferences for attributes of blood-based MCED tests, an online DCE was conducted with five attributes (true positives, false negatives, false positives, likelihood of the cancer type unknown, number of cancer types detected), among the US population aged 50-80 years recruited via online panels and social media. Data were analyzed using latent class multinomial logit models and relative attribute importance was obtained. Results: Participants (N = 1700) were 54% female, mean age 63.3 years. Latent class modeling identified three classes with distinct preferences for MCED tests. The rank order of attribute importance based on relative attribute importance varied by latent class, but across all latent classes, participants preferred higher accuracy (fewer false negatives and false positives, more true positives) and screenings that detected more cancer types and had a lower likelihood of cancer type unknown. Overall, 72% of participants preferred to receive an MCED test in addition to currently recommended cancer screenings. Conclusions: While there is significant heterogeneity in cancer screening preferences, the majority of participants preferred MCED screening and the accuracy of these tests is important. While the majority of participants preferred adding an MCED test to complement current cancer screenings, the latent class analyses identified a small (16%) and specific subset of individuals who value attributes differently, with particular concern regarding false-negative and false-positive test results, who are significantly less likely to opt-in.
MeSH term(s)	Adult ; Humans ; Female ; Middle Aged ; Male ; Early Detection of Cancer/methods ; Patient Preference ; Neoplasms/diagnosis
Language	English
Publishing date	2022-07-18
Publishing country	New Zealand
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2466680-4
ISSN	1178-1661 ; 1178-1653
ISSN (online)	1178-1661
ISSN	1178-1653
DOI	10.1007/s40271-022-00589-5
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Article: Progress in gynecologic cancer.

Seiden, Michael V

Seminars in oncology

2009 Volume 36, Issue 2, Page(s) 90

MeSH term(s)	Female ; Genital Neoplasms, Female/diagnosis ; Genital Neoplasms, Female/therapy ; Humans
Language	English
Publishing date	2009-04
Publishing country	United States
Document type	Introductory Journal Article
ZDB-ID	189220-4
ISSN	1532-8708 ; 0093-7754
ISSN (online)	1532-8708
ISSN	0093-7754
DOI	10.1053/j.seminoncol.2008.12.010
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Article ; Online: Performance of a Cell-Free DNA-Based Multi-cancer Detection Test in Individuals Presenting With Symptoms Suspicious for Cancers.

Bryce, Alan H / Thiel, David D / Seiden, Michael V / Richards, Donald / Luan, Ying / Coignet, Marie / Zhang, Quan / Zhang, Nan / Hubbell, Earl / Kurtzman, Kathryn N / Klein, Eric A

JCO precision oncology

2023 Volume 7, Page(s) e2200679

Abstract: Purpose: A multi-cancer detection test using a targeted methylation assay and machine learning classifiers was validated and optimized for screening in prospective, case-controlled Circulating Cell-free Genome Atlas (ClinicalTrials.gov identifier: ... ...

Abstract	Purpose: A multi-cancer detection test using a targeted methylation assay and machine learning classifiers was validated and optimized for screening in prospective, case-controlled Circulating Cell-free Genome Atlas (ClinicalTrials.gov identifier: NCT02889978) substudy 3. Here, we report test performance in a subgroup of participants with symptoms suspicious for cancer to assess the test's ability to potentially facilitate efficient diagnostic evaluation in symptomatic individuals. Methods: We evaluated test performance (sensitivity, specificity, and accuracy of cancer signal origin [CSO] prediction accuracy) in participants with clinically presenting cancers (CPCs) and noncancer with underlying medical conditions and among two subgroups (65 years and older and GI cancers). Overall survival (OS) of participants who had a cancer signal detected/not detected was compared with SEER-based expected survival. Results: A total of 2,036 cancer and 1,472 noncancer participants were included. Specificity was high in all noncancer participants (99.5% [95% CI, 98.4 to 99.8]). In participants with CPCs, the overall sensitivity was 64.3% (95% CI, 62.2 to 66.4) and the overall accuracy of CSO prediction in true positives was 90.3%. For GI cancers, the overall sensitivity was 84.1% (95% CI, 80.6 to 87.1). In participants 65 years and older, test performance was similar to that of all participants. Individuals with cancers not detected had a significantly better OS than that expected from SEER ( Conclusion: This test detected a cancer signal with high specificity and CSO prediction accuracy and moderate sensitivity in symptomatic individuals, with especially high performance in participants with GI cancers. The survival analysis implied that the cancers not detected were less clinically aggressive than cancers detected by the test, providing prognostic insights to physicians. This multi-cancer detection test could facilitate efficient workup and stratify cancer risk in symptomatic individuals.
MeSH term(s)	Humans ; Neoplasms/diagnosis ; Neoplasms/genetics ; Prognosis ; Prospective Studies
Language	English
Publishing date	2023-07-19
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2473-4284
ISSN (online)	2473-4284
DOI	10.1200/PO.22.00679
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Article ; Online: Advanced APMs and the emerging role of immuno-oncology agents: balancing innovation and value.

Seiden, Michael V / Neubauer, Marcus / Verrilli, Diana

The American journal of managed care

2017 Volume 23, Issue 2 Spec No., Page(s) SP69–SP77

MeSH term(s)	Humans ; Immunotherapy/economics ; Immunotherapy/methods ; Medical Oncology/economics ; Medical Oncology/methods ; Neoplasms/economics ; Neoplasms/immunology ; Neoplasms/therapy ; Reimbursement Mechanisms
Language	English
Publishing date	2017-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2035781-3
ISSN	1936-2692 ; 1088-0224 ; 1096-1860
ISSN (online)	1936-2692
ISSN	1088-0224 ; 1096-1860
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Article ; Online: Rare epithelial tumors arising in or near the ovary: a review of the risk factors, presentation, and future treatment direction for ovarian clear cell and mucinous carcinoma.

Jain, Angela / Seiden, Michael V

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting

2013

Abstract: Currently all advanced-stage epithelial ovarian cancers are treated with a total abdominal hysterectomy, bilateral oophorectomy, and complete tumor debulking surgery, followed by carboplatin and paclitaxel. This treatment recommendation is based on ... ...

Abstract	Currently all advanced-stage epithelial ovarian cancers are treated with a total abdominal hysterectomy, bilateral oophorectomy, and complete tumor debulking surgery, followed by carboplatin and paclitaxel. This treatment recommendation is based on clinical trials that are mostly populated with women with high-grade serous carcinomas. Patients with mucinous or clear cell carcinomas of the ovary tend to present with earlier-stage disease, and may not require adjuvant chemotherapy; those with advanced-stage disease tend to have carboplatin-resistant disease. Patients with mucinous ovarian carcinoma have presentations and tumor biology that are similar to colorectal carcinomas and may benefit from colorectal regimens containing fluorouracil (FU) and oxaliplatin. Their tumors may also be KRAS wild-type or have HER2 amplification, and could benefit from drugs like cetuximab or trastuzumab. Patients with clear cell carcinoma of the ovary often harbor AIRD1a mutations, an early event in oncogenesis that is not a currently drugable target. Anecdotal cases and our biologic understanding of these malignancies suggest they might be preferentially sensitive to antiangiogenesis inhibitors. Focused international trials will be needed in both of these rare epithelial ovarian cancers to better define optimal treatment regimens.
MeSH term(s)	Adenocarcinoma, Mucinous/chemistry ; Adenocarcinoma, Mucinous/diagnosis ; Adenocarcinoma, Mucinous/epidemiology ; Adenocarcinoma, Mucinous/genetics ; Adenocarcinoma, Mucinous/therapy ; Biomarkers, Tumor/analysis ; Biomarkers, Tumor/genetics ; Carcinoma, Ovarian Epithelial ; Female ; Genetic Predisposition to Disease ; Humans ; Neoplasm Staging ; Neoplasms, Glandular and Epithelial/chemistry ; Neoplasms, Glandular and Epithelial/diagnosis ; Neoplasms, Glandular and Epithelial/epidemiology ; Neoplasms, Glandular and Epithelial/genetics ; Neoplasms, Glandular and Epithelial/therapy ; Ovarian Neoplasms/chemistry ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/epidemiology ; Ovarian Neoplasms/genetics ; Ovarian Neoplasms/therapy ; Predictive Value of Tests ; Risk Factors ; Treatment Outcome
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2013-03-28
Publishing country	United States
Document type	Journal Article ; Review ; Video-Audio Media
ZDB-ID	2431126-1
ISSN	1548-8756 ; 1548-8748
ISSN (online)	1548-8756
ISSN	1548-8748
DOI	10.1200/EdBook_AM.2013.33.e200
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Article ; Online: Metastatic mucinous ovarian cancer and treatment decisions based on histology and molecular markers rather than the primary location.

Jain, Angela / Ryan, Paula D / Seiden, Michael V

Journal of the National Comprehensive Cancer Network : JNCCN

2012 Volume 10, Issue 9, Page(s) 1076–1080

Abstract: Approximately 22,000 cases of ovarian cancer occur each year in the United States, and likely fewer than 2000 cases of mucinous ovarian cancers. Although 90% of patients with mucinous ovarian cancer present with stage I disease and have curative ... ...

Abstract	Approximately 22,000 cases of ovarian cancer occur each year in the United States, and likely fewer than 2000 cases of mucinous ovarian cancers. Although 90% of patients with mucinous ovarian cancer present with stage I disease and have curative surgeries, advanced-stage disease is known to have a poor response to standard platinum- and taxane-based chemotherapy. Despite limited enthusiasm, standard chemotherapy is still recommended for most patients with advanced-stage mucinous malignancies of the ovary. This report presents an unusual case of a woman with HER2-positive metastatic mucinous carcinoma of the ovary treated with chemotherapy regimens typically used for colorectal malignancies, followed by epidermal growth factor receptor-targeted therapies.
MeSH term(s)	Antibodies, Monoclonal, Humanized/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bevacizumab ; Biomarkers, Tumor/analysis ; Brain Neoplasms/radiotherapy ; Brain Neoplasms/secondary ; Brain Neoplasms/surgery ; Cystadenocarcinoma, Mucinous/drug therapy ; Cystadenocarcinoma, Mucinous/pathology ; Cystadenocarcinoma, Mucinous/secondary ; ErbB Receptors/antagonists & inhibitors ; Female ; Humans ; Lapatinib ; Lung Neoplasms/drug therapy ; Lung Neoplasms/secondary ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/metabolism ; Ovarian Neoplasms/pathology ; Quinazolines/therapeutic use ; Receptor, ErbB-2/antagonists & inhibitors ; Receptor, ErbB-2/metabolism ; Trastuzumab ; Vascular Endothelial Growth Factors/antagonists & inhibitors ; Young Adult
Chemical Substances	Antibodies, Monoclonal, Humanized ; Biomarkers, Tumor ; Quinazolines ; Vascular Endothelial Growth Factors ; Lapatinib (0VUA21238F) ; Bevacizumab (2S9ZZM9Q9V) ; EGFR protein, human (EC 2.7.10.1) ; ERBB2 protein, human (EC 2.7.10.1) ; ErbB Receptors (EC 2.7.10.1) ; Receptor, ErbB-2 (EC 2.7.10.1) ; Trastuzumab (P188ANX8CK)
Language	English
Publishing date	2012-09-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2250759-0
ISSN	1540-1413 ; 1540-1405
ISSN (online)	1540-1413
ISSN	1540-1405
DOI	10.6004/jnccn.2012.0113
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