The Vanguard Study: Testing a New Way to Screen for Cancer
Conditions
Bladder Carcinoma, Breast Carcinoma, Colorectal Carcinoma, Esophageal Carcinoma, Gastric Carcinoma, Liver Carcinoma, Lung Carcinoma, Malignant Solid Neoplasm, Ovarian Carcinoma, Pancreatic Carcinoma, Prostate CarcinomaSummary
The Vanguard Study is a feasibility study to explore several aspects of evaluating multi-cancer detection (MCD) tests in a future definitive randomized controlled trial. An MCD test measures markers in the blood in order to screen for multiple cancers simultaneously. There is a need to understand how MCDs may work as cancer screening tools. The goal of cancer screening is to reduce the burden of cancer by identifying cancers before they show symptoms or signs, when treatment is likely to be most effective. In this study, adults aged 45-75 without cancer will be randomly assigned to one of 3 groups: 2 separate MCD test groups or a control group. These two MCD tests will not be compared to each other but will be compared to cancers detected in the control group. This study will provide early information on how well MCD tests perform as cancer screening tools. It will also help researchers understand how patients and their doctors make decisions about their care when the MCD test result comes back as normal (negative) or abnormal (positive).
Detailed Description
PRIMARY OBJECTIVES:
I. Assess the feasibility of recruitment and adherence to protocol-required baseline and follow-up data and blood collection.
II. Assess the feasibility of achieving representative enrollment across participating recruitment sites.
SECONDARY OBJECTIVES:
I. To assess the impact of participant blinding on willingness to participate, adherence to protocol required baseline and follow-up data, blood collection, and on rates of standard of care screening.
II. To determine the timeliness of returning test results to participants. III. To understand the factors contributing to lack of diagnostic resolution of an abnormal MCD test.
IV. To examine the effects of participant characteristics, including cancer risk factors and social determinants of health, on all aspects of feasibility.
V. To estimate the proportion of participants receiving an MCD test outside of the trial.
VI. To assess the feasibility of a staggered introduction of the second MCD assay intervention arm.
VII. To estimate the proportion of abnormal MCD tests that are diagnostically resolved, and the time to resolution.
VIII. To compare the proportion of participants who receive standard of care screening during follow-up between the intervention and control arms.
IX. To assess the accuracy of tissue of origin prediction for each MCD assay. X. To estimate the incidence of complications related to diagnostic evaluation of an abnormal MCD test result.
XI. To assess the effect of an abnormal MCD test and diagnostic workup on anxiety and cancer worry.
XII. To evaluate the clinical diagnostic performance of the MCD assays.
EXPLORATORY OBJECTIVES:
I. To estimate rates of late-stage cancer, and the distribution of cancer stage.
II. To estimate assay-targeted cancer-specific mortality of each MCD assay, all cancer-specific mortality, and all-cause mortality.
OUTLINE: Participants are randomized to 1 of 3 arms.
ARM I: Participants undergo blood collection for Shield MCD testing at enrollment and after one year on study. . Participants at unblinded sites are provided results of tests and those with abnormal results follow up with their clinician for additional testing. Participants at blinded sites are provided abnormal results and will follow up with their clinician for additional testing.
ARM II: Participants undergo blood collection for Avantect MCD testing at enrollment and after one year on study. Participants at unblinded sites are provided results of tests and those with abnormal results follow up with their clinician for additional testing. Participants at blinded sites are provided abnormal results and will follow up with their clinician for additional testing. (This arm is not yet open)
ARM III (Control): Participants undergo blood collection at enrollment and after one year on study.
After completion of study intervention, participants are followed passively up to 10 years.
Locations
7 locations Found with status Recruiting
Status
- RECRUITING
Contact Person
- Site Public Contact
- 405-271-8777
- [email protected]
Principal Investigator
- Scott D Ramsey
Status
- RECRUITING
Contact Person
- Site Public Contact
- 434-654-8400
Principal Investigator
- Scott D Ramsey
Status
- RECRUITING
Contact Person
- Site Public Contact
- 703-720-5210
- [email protected]
Principal Investigator
- Scott D Ramsey
Status
- RECRUITING
Contact Person
- Site Public Contact
- 757-388-2406
Principal Investigator
- Scott D Ramsey
Status
- RECRUITING
Contact Person
- Site Public Contact
- [email protected]
Principal Investigator
- Scott D Ramsey
Status
- RECRUITING
Contact Person
- Site Public Contact
- 804-628-6430
- [email protected]
Principal Investigator
- Scott D Ramsey
Status
- RECRUITING
Contact Person
- Site Public Contact
- [email protected]
Principal Investigator
- Scott D Ramsey
Eligibility Criteria
Inclusion Criteria:
* Ages 45-75 years old
* Agree to provide blood samples for possible MCD testing at enrollment and at 1 year following enrollment
* Agree to allow collection of information from their medical records for study-related purposes
* Understand and be able to complete informed consent and participant questionnaires in English, Spanish, or Arabic
* Note: Eligibility for Spanish and Arabic languages are at the Hub's discretion
Exclusion Criteria:
* Solid malignant tumor or blood cancer diagnosis, with or without treatment, within the last 5 years
* Note: Persons with a history of in situ cancers (e.g., ductal carcinoma in situ of the breast, cervical cancer in situ, atypical melanocytic hyperplasia or melanoma in situ) or nonmelanoma skin cancer are eligible
* Ongoing cancer diagnostic work-up
* Ongoing participation in another study of an investigational cancer screening test or technology
* Currently breastfeeding or pregnant, or planning to become pregnant in the next year
Study Plan
Arm I (Shield MCD test)
EXPERIMENTAL
Participants undergo blood collection for Shield MCD testing at enrollment and after one year on study. Participants at unblinded sites are provided results of tests and those with abnormal results follow up with their clinician for additional testing. Participants at blinded sites are provided abnormal results and will follow up with their clinician for additional testing.
PROCEDURE:
Biospecimen CollectionDescription:
Undergo blood collectionDEVICE:
Device UsageDescription:
Evaluation of MCD testsOTHER:
Electronic Health Record ReviewDescription:
Obtain health dataPROCEDURE:
Multi-Cancer Detection TestDescription:
Undergo Shield MCD testOTHER:
Questionnaire AdministrationDescription:
Study specific questionnaires
Arm II (Avantect MCD test)
EXPERIMENTAL
Participants undergo blood collection for Avantect MCD testing at enrollment and after one year on study. Participants at unblinded sites are provided results of tests and those with abnormal results follow up with their clinician for additional testing. Participants at blinded sites are provided abnormal results and will follow up with their clinician for additional testing. (This arm is not yet open)
PROCEDURE:
Biospecimen CollectionDescription:
Undergo blood collectionDEVICE:
Device UsageDescription:
Evaluation of MCD testsOTHER:
Electronic Health Record ReviewDescription:
Obtain health dataPROCEDURE:
Multi-Cancer Detection TestDescription:
Undergo Avantect MCD testOTHER:
Questionnaire AdministrationDescription:
Study specific questionnaires
Arm III (Control)
ACTIVE_COMPARATOR
Participants undergo blood collection at enrollment and after one year on study.
PROCEDURE:
Biospecimen CollectionDescription:
Undergo blood collectionOTHER:
Electronic Health Record ReviewDescription:
Obtain health dataOTHER:
Questionnaire AdministrationDescription:
Study specific questionnaires
Outcome Measures
Primary Outcome Measures
Feasibility of enrollment onto study
Proportion of participants who complete baseline and follow-up questionnaires within 60 days of receipt
Proportion of participants who provide the required blood sample for year 1 for Multi-Cancer Detection (MCD) testing within 90 days of recommended time point
Proportion of participants considered lost to follow-up within 2 years of randomization
Representative enrollment
Staggered start of intervention arm 2
Secondary Outcome Measures
Impact of participant blinding
Timely return of MCD test result
Factors contributing to lack of diagnostic resolution of an abnormal MCD test
Contamination
Effects of participant characteristics
Diagnostic resolution following an abnormal MCD test result
Time to diagnostic resolution
Participation in standard of care screening
Accuracy of tissue of origin prediction
Complications related to diagnostic evaluation of an abnormal MCD test result
Anxiety and Cancer Worry Questionnaire
Sensitivity of clinical diagnostic performance of each MCD assay
Specificity of each MCD assay
Test positive rates
False positives
(Targeted cancer) Positive predictive value (PPV)
(All cancer) PPV
Interval cancers
Detected cancers
(Targeted cancer) Negative predictive value
Timeline
Last Updated
August 12, 2025Start Date
May 30, 2025Today
December 7, 2025Completion Date ( Estimated )
June 30, 2029
Sponsors of this trial
Lead Sponsor
National Cancer Institute (NCI)