The evidence base for circulating tumour DNA blood-based biomarkers for the early detection of cancer: a systematic mapping review

Background: The presence of circulating cell-free DNA from tumours in blood (ctDNA) is of major importance to those interested in early cancer detection, as well as to those wishing to monitor tumour progression or diagnose the presence of activating mutations to guide treatment. In 2014, the UK Early Cancer Detection Consortium undertook a systematic mapping review of the literature to identify blood-based biomarkers with potential for the development of a non-invasive blood test for cancer screening, and which identified this as a major area of interest. This review builds on the mapping review to expand the ctDNA dataset to examine the best options for the detection of multiple cancer types. Methods: The original mapping review was based on comprehensive searches of the electronic databases Medline, Embase, CINAHL, the Cochrane library, and Biosis to obtain relevant literature on blood-based biomarkers for cancer detection in humans (PROSPERO no. CRD42014010827). The abstracts for each paper were reviewed to determine whether validation data were reported, and then examined in full. Publications concentrating on monitoring of disease burden or mutations were excluded. Results: The search identified 94 ctDNA studies meeting the criteria for review. All but 5 studies examined one cancer type, with breast, colorectal and lung cancers representing 60% of studies. The size and design of the studies varied widely. Controls were included in 77% of publications. The largest study included 640 patients, but the median study size was 65 cases and 35 controls, and the bulk of studies (71%) included less than 100 patients. Studies either estimated cfDNA levels non-specifically or tested for cancer-specific mutations or methylation changes (the majority using PCR-based methods). Conclusion: We have systematically reviewed ctDNA blood biomarkers for the early detection of cancer. Pre-analytical, analytical, and post-analytical considerations were identified which need to be addressed before such biomarkers enter clinical practice. The value of small studies with no comparison between methods, or even the inclusion of controls is highly questionable, and larger validation studies will be required before such methods can be considered for early cancer detection

Fostering Graduates’ Critical Thinking with University-Business Collaboration: The Think4Jobs Project

Literature highlights a lack of Higher Education curricula that promotes graduates’ soft skills. Critical Thinking (CT) is considered one of the soft skills associated with higher employment levels. The European-funded project “Critical Thinking for Successful Jobs” (Think4Jobs), currently in progress, aims at strengthening the collaboration between Higher Education Institutions (HEIs) and Labor Market Organizations (LMOs) to design, develop, implement and evaluate CT blended apprenticeships curricula in five disciplines (i.e., Veterinary Medicine, Teacher Education, Business and Economics, Business Informatics, English as a Foreign Language). The curricula are implemented for apprenticeships. We aim to summarize the findings and milestones achieved so far in the project. First, a focus group approach, document analysis, and observation of CT instruction in HEI and LMOs were conducted to assess the state of the art of CT teaching in HEI and the needs of the stakeholders (i.e., HE and LMO) regarding the instruction of CT in HEI apprenticeships and LMO internships. Our results revealed that there is not necessarily a “gap” between HEIs and LMOs concerning CT instruction but rather a difference in understanding and a need to develop a common language between stakeholders. Therefore, as the next step, intensive training for HE instructors and LMO tutors was conducted to establish a common understanding of CT. The results showed no statistical differences in participants’ conceptual understanding of CT, but still drew attention to several misconceptions. Finally, the CT blended apprenticeships curricula were designed as a byproduct of the University-Business Collaboration. Currently, the implementation and evaluation of the effectiveness of the CT blended apprenticeships curricula are carried out. Research Contribution: Our research within the project is deemed a relative interface that links HEIs and LMOs to establish a sustainable collaboration for developing graduates’ CT