# EpiPanGI Dx: A Cell-free DNA Methylation Fingerprint for the Early Detection of Gastrointestinal Cancers

Source: https://onco.cc/key-papers/paper-epipangi-dx-clin-cancer-res-2021/  
OnCo record `paper-epipangi-dx-clin-cancer-res-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

An academic blood test reading DNA methylation that aims to find six digestive-system cancers at once and say which organ the signal comes from.

## Summary

Kandimalla and colleagues used methylation data from 1,781 tumour and adjacent normal tissues to design a targeted bisulphite sequencing panel of 67,832 regions, then validated it in 300 cell-free DNA specimens. Cancer-specific panels reached areas under the curve of 0.98 (colorectal), 0.98 (hepatocellular), 0.94 (oesophageal squamous), 0.90 (gastric), 0.90 (oesophageal adenocarcinoma) and 0.85 (pancreatic ductal); a pan-gastrointestinal panel detected all of them with an area under the curve of 0.88; and a tissue-of-origin panel, EpiPanGI Dx, predicted the organ with accuracy of 0.85 to 0.95 for most.

## Fields

- Kind: Key paper
- Last checked: 2026-10-29
- Journal: Clinical Cancer Research
- Year: 2021
- DOI: 10.1158/1078-0432.CCR-21-1982
- Authors: Kandimalla R, Xu J, Link A, et al.
- Findings: Pan-gastrointestinal panel area under the curve 0.88.; Tissue-of-origin accuracy 0.85 to 0.95 for most gastrointestinal cancers.
- What it means: A research assay, not a product; it shows that one methylation panel can cover the digestive cancers.
- Caveats: 300 plasma specimens; no sensitivity at a stated specificity in the abstract.; No prospective or screening data.

## Sources

- Clinical Cancer Research 2021: https://doi.org/10.1158/1078-0432.CCR-21-1982
- PubMed: https://pubmed.ncbi.nlm.nih.gov/34465601/

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- technologies: [Cell-free DNA methylation tests](https://onco.cc/technologies/cfdna-methylation-testing/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/)
- drugs: [EpiPanGI Dx](https://onco.cc/drugs/epipangi-dx/)
- institutions: [City of Hope](https://onco.cc/institutions/city-of-hope/)
- journals: [Clinical Cancer Research](https://onco.cc/journals/clinical-cancer-research/)

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