{"entity":{"id":"paper-totem-genecast-bmc-cancer-2024","kind":"paper","name":"TOTEM: a multi-cancer detection and localization approach using circulating tumor DNA methylation markers","aka":[],"tldr":"Genecast's methylation blood test for seven cancers found about two in three cancers in a laboratory set at 98 to 100% specificity, and about half of early-stage cancers.","summary":"Xiong and colleagues (Kunming Medical University with Genecast Biotechnology, Wuxi) ran enzymatic-conversion targeted methylation sequencing of plasma from 500 healthy controls and 733 patients with breast, colorectal, oesophageal, gastric, liver, lung or pancreatic cancer, plus an independent cohort of 143 controls and 179 liver or stomach cancer patients. The model used 57 diagnostic markers and 873 origin markers. Specificity was 100% in testing and 98.6% in independent validation; overall sensitivity was 67.3% and 55.9%; early-stage (I and II) sensitivity was 45.7% in testing. Among correctly detected cancers the top predicted origin was right in 77.7% (testing) and 76.0% (independent validation). The authors state that real-world performance needs a much larger prospective cohort.","asOf":"2026-11-03","links":[{"label":"BMC Cancer 2024: TOTEM","url":"https://doi.org/10.1186/s12885-024-12626-7"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/39009999/"}],"tags":[],"related":[],"cancers":[],"sections":["early-detection"],"technologies":["mced","cfdna-methylation-testing"],"targets":[],"drugs":["totem-genecast"],"companies":["genecast"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["bmc-cancer"],"dependsOn":[],"notes":[],"journal":"BMC Cancer","year":2024,"doi":"10.1186/s12885-024-12626-7","pmid":"39009999","authors":"Xiong D, Han T, Li Y, Hong Y, et al.","paperType":"observational","findings":["Testing cohort: 67.3% sensitivity at 100% specificity; independent validation: 55.9% at 98.6%.","Stage I and II sensitivity 45.7% in testing.","Top predicted origin correct in 76 to 78% of detected cancers."],"whatItMeans":"A company development study with known cancers; the authors themselves say it has to be tested prospectively.","caveats":["Case-control; independent validation covered only liver and stomach cancer.","Genecast affiliation among authors."],"changedPractice":false},"route":"/key-papers/paper-totem-genecast-bmc-cancer-2024/","neighbours":{"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"technology":[{"id":"cfdna-methylation-testing","kind":"technology","name":"Cell-free DNA methylation tests","route":"/technologies/cfdna-methylation-testing/"},{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"}],"drug":[{"id":"totem-genecast","kind":"drug","name":"TOTEM (Genecast)","route":"/drugs/totem-genecast/"}],"company":[{"id":"genecast","kind":"company","name":"Genecast Biotechnology","route":"/companies/genecast/"}],"journal":[{"id":"bmc-cancer","kind":"journal","name":"BMC cancer","route":"/journals/bmc-cancer/"}]}}