Triage of patients with signs and symptoms that may indicate a brain tumour in primary care is challenging due to the common and non-specific nature of the presenting symptoms.
The DxcoverTM brain cancer liquid biopsy test was able to distinguish between patients with and without brain cancer in a published diagnostic accuracy cohort study (n=385) undertaken in secondary care that included 64 patients with known brain tumours. The negative predictive value was 95% and positive predictive value was 45%.
An exploratory cost-effectiveness model, which was based on early pre-trial data suggested the test was likely to be cost-effective if the prevalence of brain cancer in the primary care population being considered for referral was 1% or higher and a test cost of £100 was assumed. Clinical opinion suggests uncertainty around the prevalence of brain cancer in the target population.
Further work is required to: confirm the accuracy of the test in a primary care population; assess the effect of the test on patient pathways; examine impact on patient outcomes and; define the cost effectiveness.
What were we asked to look at?
We were asked to provide a high level overview of the DxcoverTM brain cancer liquid biopsy test, which uses machine learning to identify and compare patterns in the biochemical profile of serum from patients with and without brain cancer. The risk of the patient having brain cancer, based on this comparison, is calculated using computer algorithms.
Why is this important?
There is no biomarker test for brain tumours. Rather than focusing on a single biomarker for disease, the test algorithm utilises the full biological profile of the serum sample. No specialist sample preparation is required and results are available within minutes.
The developers of DxcoverTM liquid biopsy test, requested SHTG to assess evidence on the liquid biopsy test.