Newswise — COLUMBUS, Ohio – How artificial intelligence tools could help predict colon cancer aggressiveness and how the gut microbiome might provide clues to the rapid rise in colon cancers among young people are among dozens of research studies being presented by  researchers with The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) at the 2024 American Society of Clinical Oncology annual meeting, which takes place May 31 through June 4 in Chicago, Illinois. Among other emerging health topics being discussed are the use of multicancer screening tests and how equity should be a critical point of consideration in the commercial development of these tools.

Highlights of these and other research studies being presented this year follow. To learn more, visit cancer.osu.edu.

AI tool helps predict colon cancer aggressiveness to guide clinical care decisions  Investigators: Vidya Arole, MBBS, pathology and Eric Miller, MD, radiation oncology

For patients with stage II and III colon cancer medical literature suggests that chemotherapy after cancer surgery could help reduce the risk of recurrence, however, doctors must piece together information from pathologic features and other disease information to estimate how aggressive the cancer may or may not be. This study describes work to use a computer algorithm paired with clinical data to provide an objective, combined score to stratify cancer risk. This information offers important information to guide clinical care decisions about additional treatment and follow up to reduce recurrence risk. 

Predicting risk of melanoma spread to the brain in early stage disease Investigator: Merve Hassanov, MD, medical oncology

Melanoma that has spread to the brain and is detected due to symptoms has a poor prognosis, however, treatment of these lesions in their earliest, asymptomatic state is associated with better patient outcomes. Central nervous system (CNS) imaging is not regularly recommended for patient with early-stage melanoma, yet about 14% of patient with stage 2 melanoma will develop cancer in the brain. For this study, researchers aimed to predict which cancers were more likely to spread – and do so in short time period – for the purpose of directing CNS imaging to detect metastasis early on to improve overall patient outcomes. The team believes its retrospective analysis of the five-year survival data of patients with stage I-II and IIB melanoma should be considered for proactive CNS imaging to enable asymptomatic detection of CNS to improve long term survival.

Understanding how microbiome impacts early-stage cancer risk Investigator: Ning Jin, MD, medical oncology

Colorectal cancer among young adults (under age 50) has been rapidly rising, with only about 20% of cases linked to known genetic mutations that increase risk. What is driving this rise in sporadic cancers is largely unknown. Research suggests environmental factors such as a Western diet (high fat, low-fiber diet) may be associated with increased incidents of sporadic early onset colon cancer. Gut microbiomes break down and ferment dietary fibers, creating helpful gut bacteria that play an important role in keeping the intestinal lining healthy. A high-fat, low-fiber diet disrupts the microbial balance on the intestines and is associated with increased inflammation in the bowel. In this study, OSUCCC – James researchers report evidence that an increased inflammatory state related to diet may promote an immunosuppressive tumor microenvironment that allows cancer cells to evade the immune system and grow. Epigenetic analysis results also suggest that patient with early onset colorectal; cancer were 15 years older on average biologically than their chronologic age (for example 45-year-old early-onset colorectal cancer patient would have biologic characteristics more like a 60-year-old). Data suggests that the pathogenic microbes that result from poor diet may induce inflammation, which leads to accelerated aging in early onset colorectal cancer.

Multicancer detection: is it ready for prime time? Panelist: Chyke Doubeni, MD, MPH, Chief Health Equity Officer, The Ohio State University Wexner Medical Center

Multicancer detection (MCD) tests can be used to improve early cancer detection, including detection of cancers that lack effective screening methods, but are these tests appropriate for public use as a cancer-screening and detection tool? Experts, including Chyke Doubeni, MD, MPH, will discuss the potential benefits and harms of multi-cancer detection tests. Doubeni will give an equity-focused perspective on the cons of early adoption of these tests as part of a four-person panel.

Health equity challenges to using multicancer detection tests Investigator: Norah Crossnohere, PhD, researcher, internal medicine  Multicancer detection tests are an emerging screening technology to identify biomarkers of up to 50 types of cancer using a single blood sample. While these tools are considered potentially promising for early detection of many cancers, public health experts are concerned that they could also make health equity gaps in screening worse if equity is not an intentional consideration and discussion point throughout product development. This study sought to identify emerging health equity considerations related to the design, evaluation, and implementation of these tests. Findings indicate that some considerations have been made to explore equitable evaluation and implementation of these tests, but there is a limited work exploring how equity considerations related to product design. Study authors say additional attention to health equity across all phases of this screening lifecycle is crucial if multicancer detection tests are to reduce, rather than exacerbate, disparities in cancer screening using this new technology.

To learn more about ASCO research presence at the OSUCCC – James, visit cancer.osu.edu/ASCO.

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