# Exploration of multi-omics liquid biopsy approaches for multi-cancer early detection: The PROMISE study

Source: https://onco.cc/key-papers/paper-promise-innovation-2026/  
OnCo record `paper-promise-innovation-2026` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A Chinese study comparing DNA methylation, DNA mutations and proteins in blood found methylation the strongest signal for nine cancers, with proteins adding some extra cancers.

## Summary

PROMISE (NCT04972201) prospectively collected blood from 1,706 participants (866 with one of nine cancers, 840 without), split into training and validation sets. The methylation classifier outperformed mutation-based and protein-based classifiers; 95.0% of cancers detected by mutations were also detected by methylation. Combining methylation and protein features raised sensitivity to 75.1% (69.3 to 80.3) at the same 98.8% specificity, with 73.1% accuracy for the top predicted origin.

## Fields

- Kind: Key paper
- Last checked: 2026-10-29
- Journal: The Innovation
- Year: 2026
- DOI: 10.1016/j.xinn.2025.101076
- Authors: Duan J, Gao Q, Wang Z, et al.
- Findings: Methylation outperformed mutations and proteins.; Methylation plus protein: 75.1% sensitivity at 98.8% specificity; top predicted origin correct in 73.1%.
- What it means: Supports the design choice of most current tests: methylation first, with proteins as an add-on rather than mutations.
- Caveats: Case-control; known cancers.; Burning Rock affiliation among authors.

## Sources

- The Innovation 2026: PROMISE: https://doi.org/10.1016/j.xinn.2025.101076
- PubMed: https://pubmed.ncbi.nlm.nih.gov/41737326/
- ClinicalTrials.gov NCT04972201: https://clinicaltrials.gov/study/NCT04972201

## Connected records

- 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/), [Proteomics & phosphoproteomics](https://onco.cc/technologies/proteomics/)
- drugs: [OverC Multi-Cancer Detection Blood Test](https://onco.cc/drugs/overc-mcdbt/)
- companies: [Burning Rock Biotech](https://onco.cc/companies/burning-rock/)
- trials: [PROMISE (pan-cancer liquid biopsy proof of concept, Chinese Academy of Medical Sciences)](https://onco.cc/trials/promise-cams/)

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