NEW YORK – Hackensack Meridian Health (HMH) has launched a cancer risk and early detection program at the organization's Hennessy Institute for Cancer Prevention and Applied Molecular Medicine (HICAP) and is discussing the addition of multi-cancer early testing (MCED) in the near future.
"We are interested in providing a one-time genetic testing [service] to everyone who wants it," said Elias Obeid, medical director of the HICAP.
The program launched in July in collaboration with precision health company CancerIQ, whose technology HMH is using to estimate patients' cancer risk and to assist physicians in establishing personalized care plans.
"CancerIQ is really the operating system behind the entire initiative," said Feyi Ayodele, founder and CEO of CancerIQ. "We gather lifestyle cancer risk information [and] familial cancer risk information. We look at their cancer screening compliance to see if we can identify any adherence risks, and we also incorporate genetic test information to see if there are any genetic risks."
CancerIQ and HMH are jointly conducting patient outreach, seeking to interest individuals in the program via social media posts and brochures placed in clinical settings such as doctors' and mammography offices. Those interested in the program can access more information via links and QR codes embedded in these advertising materials.
The collaborators aim to target up to 100,000 individuals, although Obeid said that they expect an actual enrollment rate of between 10 and 20 percent of that total.
"We've already started seeing a high interest," Obeid said.
Patients themselves enter their data into CancerIQ's risk assessment tool and are then offered testing based on the results. If they meet the criteria for testing, then their insurer will be billed, but even if not and the patient wants testing anyway, Obeid said that the test costs $150 out of pocket and the HICAP will be able to assist individuals unable to afford that.
In addition to providing its risk assessment tools, Chicago-based CancerIQ analyzes the patient data in an effort to both help providers monitor patient health and to facilitate ongoing research, which is another key program aim.
The initiative with HMH is the latest cancer risk assessment collaboration for CancerIQ. The company, which closed a $14 million Series B funding round in 2022, has also partnered with Roseville, California-based Adventist Health to better identify patients who would benefit from genetic testing.
Although not part of the current program, HMH also hopes to be able to begin offering MCED testing in the near future. The organization has been discussing this with Grail and "two other companies" that provide such tests, but nothing has yet been finalized.
Grail has recently found itself under greater scrutiny following a report in the British Medical Journal revealing UK health officials' concerns that the performance of Grail's Galleri MCED test has been overhyped and suggesting that a clinical trial of Galleri, conducted by the UK National Health Service, may be unsuitable to justify a national screening test.
The US Centers for Medicare and Medicaid Services, meanwhile, recently launched a three-year investigational device exemption study of the Galleri assay called REACH. The first patient in that trial was enrolled last month.
Researchers and medical practitioners are actively debating the role that MCED in general can and should play in patient care. In particular, some are debating what the best endpoints in MCED trials should be. The primary endpoint of the REACH trial, for instance, is incidence rates of stage IV cancers, while some experts are arguing for survival endpoints, which would take much longer to assess.
Obeid acknowledged that the data on MCED performance and utility remains in early stages but said that enough exists now to show that these tests do no harm while possibly providing some benefit. With respect to the UK study, he said that the NHS's decision to hold off on incorporating MCED into a national-level program until more longitudinal data is available appeared sensible, but he argued that nothing published to date suggests that there is a "problem" with the Galleri test.
"I think it's just that the data is not yet mature [enough] for [the NHS] to offer it," he said.
Obeid explained that offering MCED testing at the HICAP in the near future serves two purposes: Such testing can still provide physicians with actionable information, and it enables the institute to collect more data on MCED test performance, which it can use to refine its programs going forward.
"If you just wait for the data, you might be missing the boat," Obeid said.
In its discussions with Grail and other test providers, the HICAP seeks to determine which test will be the most appropriate to use, both scientifically and in terms of cost to payors. Obeid said that the institute hopes to have made its decision by the end of October.
Obeid also mentioned that while MCED isn't a part of what CancerIQ offers, the company has expressed interest in what HMH might do with it and that it could be involved in later collaborations.
The HMH cancer testing program is currently in place at the John Theurer Cancer Center in Hackensack, New Jersey. HMH plans to expand the program to its center in Clifton, New Jersey, early next year.