Genetic Cytology for Ovarian and Endometrial Cancer Screening

DESCRIPTION provided by applicant In this Fast Track application a path to commercialization will be pursued for a breakthrough andquot genetic cytologyandquot test capable of detecting both ovarian and endometrial cancer from routinely collected Pap specimens In deference to the notable success of the Pap test in reducing deaths due to cervical cancer and in reference to the core enabling genetic sequencing technology this new test has been named PapGene The PapGene test detects ovarian and endometrial cancers by applying newly affordable sequencing technology to Pap specimens specimens that are safely and routinely collected from million women each year in the United States The PapGene test is a genetic cytology assay that achieves sensitivity and specificity through identifying DNA mutations causative of cancer from routinely collected clinical specimens With traditional cytology e g Pap testing cells are subjectively analyzed for abnormal cell morphology through visualization by light microscopy The PapGene test allows cells to be analyzed objectively with a massively parallel sequencing based assay The test uses a proprietary sequencing error reducing strategy to accommodate the relatively low proportions of cancer derived DNA that may exist in clinical specimens In Phase I this study will determine the accuracy precision analytical sensitivity analytical specificity reportable range and reference range of the PapGene genetic cytology assay Aim A retrospective study will also be completed on previously collected samples to demonstrate the clinical validity of the PapGene assay Aim In Phase II this study will demonstrate clinical utility of the PapGene test for women at high risk for ovarian and endometrial cancer A prospective study will be completed by applying the PapGene assay to two prospective cohorts patients with postmenopausal bleeding undergoing endometrial biopsy and patients with a germline BRCA or BRCA undergoing Risk Reducing Salpingo Oophorectomy RRSO Aim Regulatory approval for the PapGene test will be pursued by establishing a CLIA certified laboratory for high complexity testing to allow for commercial use of a Laboratory Developed Test LDT Discussions with the FDA will be started regarding premarket clearance and approval for the PapGene test to allow for more widely distributed use Aim PUBLIC HEALTH RELEVANCE This research will advance the development of a clinically useful genetic cytology assay for the detection of early stage endometrial and ovarian cancer Future benefits include the potential availability of a screening test to detect ovarian and endometrial cancer while still surgically curable