A Global Quest For Understanding Cancer Signal In Blood


Charles Hayfron-Benjamin, MD, University of Ghana, pictured with patient. Image courtesy of Latif Musah.

November 20, 2024 - by Sarah Paris

In an outstanding example of team science, Stanford researchers will lead a major multinational project to study biology of cancer development in blood.

The International Consortium on a Cancer Biomarker for Early Detection (INTERCEPT) will investigate traditional and novel risk factors, including biomarkers, for several types of cancers in the United States, Ghana, Israel, Japan, and Taiwan.

Among the unique strengths of the study are: its large size (3,840 participants); the inclusion of multiple forms of cancer; a diverse, multi-ethnic population; the parallel investigation of biology, and psychological and environmental risk factors, such as loneliness, mental health, well-being, and climate change. The study will also assess the association of genomic and immunologic biomarkers with cancer status.

Professor of Medicine Ann Hsing, PhD, is the PI of the project. Hsing and her team at Stanford, including 16 faculty and over 25 staff, will work with established U.S. and international collaborators.

The multidisciplinary international team includes more than a dozen leading researchers from each of the participating countries, with expertise in epidemiology, clinical medicine, oncology, surgery, gastroenterology, virology, molecular biology, biochemistry, and nutrition (see table at end). The diversity of the researchers’ home populations, combined with their collective knowledge base, will provide fertile ground for new discoveries.

Some types of cancers have the potential to yield blood-based biomarkers that would allow for timely treatment at an early stage for more cures and other improved outcomes. The consortium aims to enroll 2,560 cancer patients, most with localized malignancies, along with half as many controls. Researchers will analyze blood samples using panels of known and novel biomarkers. They will also scrutinize information from electronic medical records and self-reported data to identify additional relevant factors for each form of cancer.

The study will build an international biobank of as many as 140,000 specimens and a large database that will be housed at Stanford Medicine for future collaborations and investigations into cancer prevention.

“This complex project could not have been developed without the collective effort of a great many people. I am truly grateful for everyone’s commitment, patience, and contributions through this long process,” said Hsing.

INTERCEPT will investigate traditional and novel risk factors, including biomarkers, for several types of cancers in the United States, Ghana, Israel, Japan, and Taiwan. Image courtesy of Dall-E 3.

Essential for Success: Communication and Collegial Support

In addition to the complexity of scientific collaboration across five countries, working with individuals from many disciplines beyond medical science – including lawyers, regulatory experts, finance professionals, and marketing teams – means hearing many different languages. “In a situation like this, it is very important to listen closely and ask for clarification in order to have effective communication,” said Hsing.

Institutional support, from the beginning, is essential to success. Hsing acknowledged the support of her chief, without which, she said, it would not have been possible to reach the negotiation finish line.

“Dr. Hsing is gifted in her ability to build a team that is united in a common purpose. She has incredible determination and persistence. My role was simple to remove barriers and cheer her on,” said David Maron, MD, chief of the Stanford Prevention Research Center (SPRC).

A Team for the Long Haul

Any large, long-term project is built by teams, and trust and emotional support are the mortar that hold the bricks together. “You need to tap into your network to navigate through the process and through times when you might get discouraged,” Hsing said. She extends her gratitude to all the co-investigators (see table at end) and her colleagues at SPRC, especially: Drs. Maron, Jodi Prochaska, and Christopher Gardner; Drs. PJ Utz and Mike Helms from the Team Science program; Senior Associate Dean for Research Ruth O’Hara; and Deputy Chief Information Officer Michael Halaas.

Sunita Rajdev and Roxana Malene in the Contracts Office provided “an amazing effort,” according to Hsing. She also cites Holly Osborne and Becky Earl in the Research Management Group, who “spent countless hours collaborating with me on the budget and budget justifications.” All in all, Hsing’s team worked on the scientific proposal, common protocol, survey, IRB protocol, and the contract finalization for 24 months, from inception to signing.

“Most cancers, especially gastrointestinal cancers, are diagnosed late, with a high fatality, so early cancer diagnosis and treatment form the basis for cure in patients with this disease,” said Andrew Adjei, PhD, who leads the team in Ghana. “INTERCEPT is a landmark study that will set the stage for unveiling hidden biomarkers that herald the onset or the presence of these cancers in the early stages. Risk factors that are particular to different geographical regions will be identified. The University of Ghana is privileged to be part of this international consortium targeting early cancer detection and improving cancer prevention.”

Having the biobank and database housed at Stanford means these resources will be available to scientists at Stanford, consortium investigators, and its collaborators, providing opportunities for future research.

For more information or questions about INTERCEPT, contact interceptstudy@stanford.edu.


INTERCEPT

Collaborators by Study Site

Site Name Affiliation Expertise
Stanford

Ann Hsing, PhD, PI

Stanford Prevention Research Center (SPRC), Department of Medicine

Cancer epidemiology, population health, field studies, biomarkers, molecular epidemiology, lung and liver cancer epidemiology and screening 

Ying Chen, PhD 

SPRC, Department of Medicine

Biostatistics, Data Coordinating Center 

Esther John, PhD

Department of Epidemiology and Population Health

Cancer epidemiology, population health, filed studies, lifestyle factors 

Christopher Gardner, PhD

SPRC, Department of Medicine

Nutrition, early detection and intervention studies

Joe Shrager, MD

Department of Thoracic Surgery

Lung cancer and diseases, lung cancer screening

Natalie Lui, MD

Department of Thoracic Surgery

Lung cancer, cancer disparities, lung cancer screening

Mindie Nguyen, MD

Department of Medicine

Liver cancer, viral hepatitis, NAFLD, clinical epidemiology, liver cancer screening

Che-Hong Chen, PhD

Department of Systems Biology

Early detection, esophagus cancer, ALDH2, molecular biology 

Joo Ha Hwang, MD

Department of Medicine

Gastric and pancreas cancer, biomarkers, GI cancer screening  

Robert Huang, MD

Department of Medicine

Gastric cancer screening, epidemiology

Uri Ladabaum, MD

Department of Medicine

Colon cancer, early detection, screening  

Oliver Dorigo, MD

Department of Obstetrics & Gynecology - Oncology

Ovarian cancer, prevention 

Clete Kushida, MD, PhD

Department of Psychiatry and Behavior Sciences

Sleep, obstructive sleep apnea

Julie Thai, MD

Department of Primary Care and Population Health

Geriatrics, public health

Kaiser Permanente

Lori Sakoda, PhD

Division of Research, Kaiser Permanente Northern California  

Epidemiology, lung cancer screening, biomarker studies

Taiwan

Jaw-Town Lin, MD, PhD

E-Da University

Gastric, esophageal, and pancreatic cancer, H pylori, and early detection

Jin-Shing Chen, MD 

National Taiwan University

Lung cancer etiology, early detection, prevention, and surgery  

Ghana

Andrew Adjei, PhD

University of Ghana

Biochemistry, molecular epidemiology

Israel

Nadir Arber, MD

Tel Aviv University Sourasky Medical Center

Colorectal cancer, GI screening, early detection

Raanan Berger, MD

Sheba Medical Center

Prostate cancer, tumorigenesis

Japan

Manabu Muto, MD, PhD

Kyoto University

Esophageal cancer