# Noninvasive detection of any-stage cancer using free glycosaminoglycans

Source: https://onco.cc/key-papers/paper-bratulic-gagome-pnas-2022/  
OnCo record `paper-bratulic-gagome-pnas-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Elypta's founding study: patterns of sugar molecules called glycosaminoglycans in urine and blood told people with 14 cancer types from healthy people, including some stage I cancers.

## Summary

Bratulic and colleagues profiled free glycosaminoglycans (GAGomes) in urine and plasma as metabolic biomarkers for multi-cancer early detection across 14 cancer types, using 2,064 samples from 1,260 people with cancer or healthy. Machine-learning models on urine (220 cancer, 360 healthy) and plasma (517 cancer, 425 healthy) detected any cancer with an area under the curve of 0.83 to 0.93, with up to 62% sensitivity for stage I disease at 95% specificity, and predicted the putative cancer location with 89% accuracy. In a validation on a screening-like population requiring at least 99% specificity, combined GAGomes predicted any cancer type with poor prognosis within 18 months with 43% sensitivity (21% at stage I; 121 and 49 cases).

## Fields

- Kind: Key paper
- Last checked: 2026-10-29
- Journal: Proceedings of the National Academy of Sciences
- Year: 2022
- DOI: 10.1073/pnas.2115328119
- Authors: Bratulic S, Limeta A, Dabestani S, et al.
- Findings: Area under the curve 0.83 to 0.93 across urine and plasma models.; Up to 62% stage I sensitivity at 95% specificity.; Screening-like validation at 99% specificity: 43% sensitivity, 21% at stage I.; Cancer location predicted with 89% accuracy.
- What it means: A signal that is not DNA at all, read from urine as well as blood. At the 99% specificity a screening test needs, it found about one in five stage I cancers in the screening-like set, similar to the DNA tests.
- Caveats: Mostly case-control; the screening-like validation had 121 cases.; Authors include Elypta's founders.

## Sources

- PNAS 2022: GAGomes: https://doi.org/10.1073/pnas.2115328119
- PubMed: https://pubmed.ncbi.nlm.nih.gov/36469776/

## Connected records

- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- technologies: [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/)
- drugs: [Elypta GAGome multi-cancer test](https://onco.cc/drugs/gagome-mced-test/)
- companies: [Elypta](https://onco.cc/companies/elypta/)
- journals: [Proceedings of the National Academy of Sciences](https://onco.cc/journals/pnas/)

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