# Avantect Multi-Cancer Detection Test

Source: https://onco.cc/drugs/avantect-mcd/  
OnCo record `avantect-mcd` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

ClearNote Health's blood test for several cancers, one of the two tests in the US National Cancer Institute's randomised Vanguard study, with no published performance figures yet.

## Summary

ClearNote Health (formerly Bluestar Genomics) built the Avantect Multi-Cancer Detection test on its 5-hydroxymethylcytosine epigenomic platform, which it also uses for single-cancer pancreatic and ovarian tests. ClearNote's 7 January 2025 release describes detection of the presence of cancer along with its likely tissue of tumour origin and says the test was designed to detect some of the deadliest cancers; it gives no number of cancer types. ClearNote's peer-reviewed multi-cancer work (Xue et al., Communications Biology 2025) analysed 5-hydroxymethylcytosine in cell-free DNA from 1,009 people with breast, colon, lung, ovarian or pancreatic cancer and 1,678 without, and predicted the tissue of tumour origin with 85.2% accuracy; it does not report a screening sensitivity or specificity for the commercial test. The single-cancer Avantect pancreatic test, on the same platform, is analytically validated (Chowdhury et al., Journal of Molecular Diagnostics 2024).

The NCI selected it, with Guardant's Shield MCD, for the randomised Vanguard feasibility study (NCT06995898); it is also in an Inova pilot of intensive screening for veterans exposed to burn pits (NCT07485322). ClearNote announced UKCA marking for the Avantect Multi-Cancer and Ovarian tests on 25 September 2025. In the US its tests are offered from ClearNote's CLIA-certified, CAP-accredited laboratory and have not been cleared or approved by the FDA, as the company states. No price was found.

## Fields

- Kind: Treatment
- Status: emerging
- Last checked: 2026-10-29
- Also known as: Avantect MCD; Avantect multi-cancer
- Tags: test; mced; evidence:insufficient
- Brand: Avantect
- Modality: Multi-cancer early detection blood test (cell-free DNA 5-hydroxymethylcytosine)
- Mechanism: Captures 5-hydroxymethylcytosine, a chemical mark on DNA, together with genomic features in cell-free DNA, and uses machine learning to report a cancer signal and its likely tissue of origin.

## Notes

- Evidence grade insufficient for the claim that taking this test reduces late-stage diagnosis or cancer deaths: no randomised trial of it has reported either outcome, and its published performance comes from case-control or single-arm studies. The only randomised result for any multi-cancer test, NHS-Galleri, did not show fewer stage III or IV cancers.
- What a result means: a positive result is a reason for further tests, not a diagnosis; a negative result does not rule cancer out and does not replace the screening tests that have been shown to work (bowel, breast, cervical and, where eligible, lung screening).
- No peer-reviewed sensitivity, specificity or stage I figure for the multi-cancer test was found on 29 October 2026.

## Sources

- Xue et al., Communications Biology 2025 (5hmC across five cancers): https://doi.org/10.1038/s42003-025-09017-4
- Chowdhury et al., Journal of Molecular Diagnostics 2024 (Avantect pancreatic): https://doi.org/10.1016/j.jmoldx.2024.06.007
- NCI selects two assays for the Vanguard Study: https://prevention.cancer.gov/news-and-events/news/nci-selects-two-assays-vanguard-study-multi-cancer-detection-tests
- ClearNote Health: https://www.clearnotehealth.com/
- ClinicalTrials.gov NCT06995898: https://clinicaltrials.gov/study/NCT06995898

## Connected records

- drugs: [Shield MCD (Shield Multi-Cancer Detection)](https://onco.cc/drugs/shield-mcd/)
- technologies: [DNA methylation profiling](https://onco.cc/technologies/methylation-profiling/), [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/)
- companies: [ClearNote Health](https://onco.cc/companies/clearnote-health/)
- trials: [ClearNote Health multi-cancer epigenomics study](https://onco.cc/trials/clearnote-multi-cancer-epigenomics/), [Inova burn pit veterans cancer screening pilot](https://onco.cc/trials/inova-burn-pit-screening/), [Vanguard Study (NCI Cancer Screening Research Network)](https://onco.cc/trials/vanguard-study/)

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