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PATHFINDER 2: A Multi-Cancer Early Detection Study

The PATHFINDER 2 Study: Evaluating the Safety and Performance of the GRAIL Multi-Cancer Early Detection Test in an Eligible Screening Population

Status
Active, not recruiting
Phases
Unknown
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05155605
Enrollment
35883
Registered
2021-12-13
Start date
2021-12-08
Completion date
2028-04-30
Last updated
2026-05-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cancer, Early Detection of Cancer

Keywords

multi-cancer early detection, cancer screening, circulating cell-free tumor DNA, MCED

Brief summary

This is a prospective, multi-center interventional study of the GRAIL multi-cancer early detection (MCED) test with return of test results for participants enrolled through healthcare systems in North America. The purpose of this study is to evaluate the safety and performance of the GRAIL MCED test in a population of individuals who are eligible for guideline-recommended cancer screening. In cases with a "cancer signal detected" test result, participants will undergo diagnostic procedures based on the test returned cancer signal origin(s) to determine if they have cancer. The number and types of diagnostic procedures required to achieve diagnostic resolution will be assessed. Participant-reported outcomes will be collected at several time points to assess participants' perceptions about the multi-cancer early detection test. The study will enroll approximately 35,000 and no more than 38,500 participants as defined by eligibility criteria over an anticipated enrollment period of approximately 36 months at up to 40 clinical institutions within North America. Participants will be actively followed for approximately 3 years from the date of their enrollment.

Interventions

Blood collection and multi-cancer early detection testing with return of results.

Sponsors

GRAIL, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SCREENING
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

1. Participants must be at least 50 years of age, inclusive, at the time of signing the Informed Consent Form (ICF). 2. Participants must be capable of giving signed and legally effective informed consent

Exclusion criteria

1. Undergoing or referred for diagnostic evaluation due to clinical suspicion for cancer (e.g., referred to a medical or surgical oncologist, or scheduled for biopsy on the basis of a suspicious imaging abnormality). 2. Personal history of invasive solid tumor or hematologic malignancy, diagnosed within the 3 years prior to expected enrollment date, or diagnosed greater than 3 years prior to expected enrollment date and never treated. * Individuals with a diagnosis of non-metastatic basal cell carcinoma and squamous cell carcinoma of the skin are not excluded. 3. Prior/Concurrent Concomitant Therapy (Medications/Treatments): * Definitive treatment for invasive solid tumor or hematologic malignancy within the 3 years prior to expected enrollment date. Adjuvant hormone therapy for cancer (e.g. for breast or prostate cancer) is not an exclusion criterion. 4. Individuals who will not be able to comply with the protocol procedures. 5. Individuals who are not currently registered patients at a participating center. 6. Previous or current participation in another GRAIL-sponsored study. "Participation" is defined as having signed consent and provided a blood sample. 7. Previous or current employees or contractors of GRAIL. 8. Current pregnancy (by self-report of pregnancy status)

Design outcomes

Primary

MeasureTime frame
Safety: Number and type of invasive procedures performed in participants with a cancer signal detected by the multi-cancer early detection (MCED) test and no cancer diagnosis at the time of diagnostic resolution (i.e., false positive test result).Up to 3 Years
Test performance: diagnosis of invasive cancer, assessed by positive predictive value (PPV).Up to 3 Years
Test performance: diagnosis of invasive cancer, assessed by negative predictive value (NPV).Up to 3 Years
Test performance: diagnosis of invasive cancer, assessed by sensitivity.Up to 3 Years
Test performance: diagnosis of invasive cancer, assessed by specificity.Up to 3 Years
Test performance: diagnosis of invasive cancer, assessed by cancer signal origin (CSO) accuracy.Up to 3 Years
Test performance: diagnosis of invasive cancer, assessed by observed cancer detection rate (CDR).Up to 3 Years
Test performance: diagnosis of invasive cancer, assessed by number needed to screen to detect an invasive cancer (NNS).Up to 3 Years

Secondary

MeasureTime frame
Participant-reported anxiety resulting from use of the multi-cancer early detection (MCED) test assessed via questionnaire at various time points during the study.Up to 3 Years
Participant-reported intention to follow and use guideline recommended cancer screening procedures after use of the multi-cancer early detection (MCED) test assessed via questionnaire at various time points during the study.Up to 3 Years
Cancer detection rate of confirmatory PET-CT in participants for whom cancer signal origin directed workups do not result in diagnosis of cancer.Up to 3 Years
Number and type of diagnostic evaluations (imaging procedures, invasive procedures, laboratory test) by predicted cancer signal origin and outcome of diagnostic resolution.Up to 3 Years
Per-participant radiation exposure during diagnostic evaluation for test positive participants.Up to 3 Years
Accuracy of initial multi-cancer early detection (MCED) test result and cancer signal origin prediction, among the subset of participants with a research blood draw.Up to 3 Years
Participants-reported perceptions about the multi-cancer early detection (MCED) test including satisfaction with the MCED tests and attitudes towards subsequent MCED testing assessed via questionnaire at various time points during the study.Up to 3 Years

Countries

Canada, United States

Contacts

STUDY_DIRECTORCeline Marquez, MD

GRAIL, Inc.

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Jun 5, 2026