SYMPLIFY – assessing a multi-cancer early detection test in individuals referred with signs and symptoms of cancer

ISRCTN ISRCTN10226380
DOI https://doi.org/10.1186/ISRCTN10226380
ClinicalTrials.gov (NCT) Nil known
Clinical Trials Information System (CTIS) Nil known
Integrated Research Application System (IRAS) 299310
Central Portfolio Management System (CPMS) 49672
Protocol serial number OCTO_105
Sponsor University of Oxford
Funder Grail Bio UK Ltd
Submission date
24/06/2021
Registration date
13/08/2021
Last edited
08/12/2025
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Cancer is easier to treat if it is diagnosed early. The NHS has developed rapid referral pathways to allow cancers to be diagnosed earlier, but this requires us to run tests on a lot more people than turn out to have cancers. This creates worry for some people, may not be the most efficient use of NHS resources, a significant proportion of cancers are diagnosed via other routes, often when it is too late to cure them.
We know that the DNA from cancers can be detected in the blood early on and want to use this fact to detect cancers earlier than existing pathways. In this study we want to check the performance of one such multi-cancer early detection (MCED) test.

Who can participate?
People sent to one of 5 rapid referral pathways by their GP because they have symptoms that might be due to cancer.

What does the study involve?
People taking part in the study will have their diagnostic test(s) in the normal way, but will also give a blood sample and permission for us to check their health records later to see if they were diagnosed with cancer and what appointments and other tests they had.
At the end of the study, having tested the blood with the MCED test, we will understand more about how well it works in this group of people, and expect that this will help us to design another trial where we check how to use the test to decide who needs rapid referral to look for a possible cancer and what tests to use following a positive MCED result.

What are the possible benefits and risks of participating?
If someone participates, they will be contributing to important research into how to detect cancer early. This may benefit people in the future. If the GalleriTM test turns out to detect cancer early, we may be able to treat more cancers more successfully
We will do everything we can to make sure participants in this study don’t experience any harm. They will need to give a blood sample. Although this process is generally safe, they may experience discomfort or light-headedness, and there is a small risk of infection. If blood needs to be taken as part of their hospital care, the research blood sample will be taken at the same time.

Where is the study run from?
University of Oxford (UK)

When is the study starting and how long is it expected to run for?
February 2021 to November 2022

Who is funding the study?
Grail Bio UK Ltd

Who is the main contact?
Sarah Pearson, octo-symplify@oncology.ox.ac.uk

Contact information

Mrs Sarah Pearson
Public

OCTO, Dept of Oncology
University of Oxford
Old Road Campus Research Building
Old Road Campus
Roosevelt Drive
Oxford
OX3 7DQ
United Kingdom

ORCiD logoORCID ID 0000-0001-5386-1953
Phone +44 (0)1865 227170
Email octo-symplify@oncology.ox.ac.uk

Study information

Primary study designObservational
Study designProspective observational multi-centre cohort
Secondary study designCohort study
Scientific titleSYMPLIFY – Observational study to assess a multi-cancer early detection test in individuals referred with signs and symptoms of cancer
Study acronymSYMPLIFY
Study objectivesTo evaluate the performance of a multi-cancer early detection (MCED) test for the detection of invasive cancer and the identification of cancer signal origin
Ethics approval(s)Approved 22/06/2021, London Central REC (Barlow House, 3rd Floor, 4 Minshull Street, Manchester, M1 3DZ, UK; +44 (0)207 104 8225; londoncentral.rec@hra.nhs.uk), ref: 21/LO/0456)
Health condition(s) or problem(s) studiedEarly detection of cancer
InterventionParticipants will be asked to give consent and provide a single blood sample during one visit to hospital. After that the participants have no further direct involvement, all follow-up is through collection of data. We collect data on participants at 3 and 12 months from registration into the study to find out whether or not they had a diagnosis of cancer. (We will also do a check at 9 months to collect any data that was not available at the 3 month timepoint).
Intervention typeOther
Primary outcome measure(s)

At an interim analysis within 3 months of complete enrolment with complete analysis at 12 months of enrolment, measured by comparing blood sample analysis and patient notes:
1. Positive Predictive Value
2. Negative Predictive Value
3. Sensitivity
4. Specificity
5. Cancer signal origin accuracy

Key secondary outcome measure(s)

At an interim analysis within 3 months of complete enrolment with complete analysis at 12 months of enrolment, measured by comparing blood sample analysis and patient notes:
1. Concordance between referral pathway selected by GP and CSOs identified by MCED
2. Number of true positives/number of patients referred within each referral pathway

Completion date30/11/2022

Eligibility

Participant type(s)Patient
Age groupMixed
Lower age limit18 Years
Upper age limit100 Years
SexAll
Target sample size at registration6000
Total final enrolment6238
Key inclusion criteria1. Participants referred to an RDC or relevant 2WW pathway to rule a cancer diagnosis in or out will be invited to participate in the study.
2. Willing and able to give informed consent for participation in the study.
3. Male or Female, aged 18 years or above.
4. Referred to a RDC or a gynae, lung, upper GI or lower GI cancer 2WW pathway.
Key exclusion criteria1. Has a history of invasive or haematological malignancy diagnosed within the previous 3 years.
2. Has undergone definitive treatment for invasive or haematological malignancy in the last 3 years (adjuvant hormone therapy is permissible in this context).
3. Is taking cytotoxic or demethylating agents such as methotrexate.
4. Previous or current participation in another GRAIL study. “Participation” is defined as having signed consent and provided a blood sample.
Date of first enrolment05/07/2021
Date of final enrolment30/11/2021

Locations

Countries of recruitment

  • United Kingdom
  • England
  • Wales

Study participating centres

Southampton General Hospital
University of Southampton and University Hospital Southampton NHS Foundation Trust
Tremona Road
Southampton
SO16 6YD
England
Buckinghamshire Healthcare NHS Trust
Mandeville Road
Aylesbury
HP21 8AL
England
Churchill Hospital
Oxford University Hospitals NHS Foundation Trust
Old Road
Headington
Oxford
OX3 7LE
England
Royal Berkshire Hospital
Royal Berkshire NHS Foundation Trust
London Road
Reading
RG1 5AN
England
Basildon and Thurrock University Hospital
Mid and South Essex NHS Foundation Trust
Nethermayne
Basildon
SS16 5NL
England
Torbay & South Devon Foundation Trust
-
Torquay
TQ2 7AA
England
Royal Cornwall Hospital
Royal Cornwall Hospital NHS Trust
Truro
TR1 3HD
England
Royal Free Hospital
Royal Free London NHS Foundation Trust
Pond Street
London
NW3 2QG
England
University College London Hospital
University College London Hospitals NHS Foundation Trust
250 Euston Road
London
NW1 2PG
England
North Middlesex University Hospital NHS Trust
-
London
N18 1QX
England
York Hospital
York & Scarborough Teaching Hospitals NHS Foundation Trust
York
YO31 8HE
England
Hull University Teaching Hospitals NHS Trust
-
Hull
HU16 5JQ
England
Wales - multiple hospitals under one lead site (Velindre NHS Trust)
-
Cardiff
CF14 2TL
Wales
Chelsea and Westminster Hospital NHS Foundation Trust
Chelsea & Westminster Hospital
369 Fulham Road
London
SW10 9NH
England

Results and Publications

Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 20/06/2023 26/06/2023 Yes No
HRA research summary 28/06/2023 No No
Other publications A comparison of cancer data obtained on-site during SYMPLIFY with data from English and Welsh national cancer registries 09/10/2024 17/10/2024 Yes No
Plain English results 08/12/2025 No Yes
Study website 11/11/2025 11/11/2025 No Yes

Editorial Notes

08/12/2025: Cancer Research UK plain English results link added.
17/10/2024: Publication reference added.
26/06/2023: Publication reference added.
20/04/2023: Chelsea and Westminster Hospital NHS Foundation Trust has been added to the trial participating centres.
27/09/2022: The following changes were made to the trial record:
1. The recruitment end date was changed from 30/09/2021 to 30/11/2021.
2. The overall end date was changed from 30/09/2022 to 30/11/2022.
3. The total final enrolment was added.
4. The plain English summary was updated to reflect these changes.
07/09/2021: Internal review.
09/07/2021: Trial's existence confirmed by London Central REC.