AACR: Adela's multi-cancer blood test shows promise in detecting early stage tumors

Canadian newcomer Adela has shown that its test for detecting the faint traces of cancer in the bloodstream could spot 12 different types of the disease, including many in their early stages when they have the best chances of being treated.

The Toronto-based startup presented the results of a retrospective study at the annual meeting of American Association for Cancer Research in Orlando, Florida, based on an analysis of archived blood samples from about 4,000 patients.

The different cancers included bladder, breast, colorectal, endometrial, esophageal, lung, ovarian, pancreatic, prostate, kidney, head and neck, and the liver, gallbladder and bile ducts. 

The test developed by Adela, a company formerly known as DNAMx, searches for the small pieces of tumor DNA that are released from dying cancer cells into the bloodstream. These can be traced back to their origins by analyzing their patterns of methylation, or the molecules attached to DNA strands that help govern which genes are turned on or off.

“Different methylation patterns exist between cancerous and non-cancerous cells,” Ben Ho Park, director of the Vanderbilt-Ingram Cancer Center, said in a release.

These abnormal patterns can also be a key driver of cancer cells’ continuous growth, said Park, who presented the study at the AACR meeting. “In addition, there are shared methylation patterns across cancer types, as well as differentially methylated regions that are tissue-specific.” 

One of the highest-profile pursuers of DNA methylation for the detection of cancer has been the blood test developer Grail—the subject of a $8 billion acquisition deal penned by Illumina, and a current source of headaches in the gene sequencing giant’s dealings with international antitrust regulators and activist investors.

Grail’s Galleri test—which launched in 2021 following years of development, massive trials spanning tens of thousands of participants, and the raising of about $2 billion in venture capital funds—has shown an ability to detect as many as 50 different types of cancer. 

Grail, first launched as a spinout from Illumina, had initially built its test on large-scale genomic sequencing to find specific mutations, before landing on DNA methylation as key biomarker. Other cancer blood test developers, such as Delfi, Exact SciencesFreenome, and Guardant Health have also explored methylation and next-generation sequencing, in addition to protein levels and other potential signals of underlying cancer.

Adela’s approach, meanwhile, aims to isolate and capture the state of methylation across the cancer genome using a machine learning algorithm—but without pre-treatment with chemicals or enzymes that may damage genetic material, and without needing to decode the entire sequence of DNA—to hopefully make its methods more cost-effective.

The company said its preliminary study results showed its test could tell the difference between blood samples that had evidence of cancer and those that didn’t 94% of the time, including all cancer types and stages. 

About half of the samples with cancer were in stage I and stage II, and were correctly spotted 92% and 95% of the time, respectively. Stage III and IV cancers were identified at rates of 95% and 97%.

“Cancers that shed a high amount of [cell-free DNA] had the best performance, but even cancers that are typically difficult to detect with cfDNA assays were detected with high performance in this interim readout,” said Park, who added that the findings will need to be confirmed in more prospective studies before the test will reach patients.

Adela is currently enrolling more than 5,000 U.S. participants for an observational study, including people with tumors types that contribute to more than 90% of cancer cases and more than 85% of cancer deaths, as well as control groups of people without a diagnosis. 

The company is also developing its approach for tests that monitor for minimal residual disease and cancer recurrence. Adela made its debut in 2021 with $60 million in series A financing, with the round led by F-Prime Capital and backed by OrbiMed, Deerfield Management, Decheng Capital and RA Capital Management.