The Four Protein Biomarker Blood Test Improves Risk Assessment of Lung Cancer in Smokers

July 12, 2018

A Four Protein Biomarker Blood Test Improves Lung Cancer Risk Assessment Against Existing Guidelines That Are Based Only on the History of Smoking, Capturing the Risk for people who have already smoked. "This simple blood test demonstrates the potential of biomarker-based risk badessment to improve eligibility criteria for lung cancer screening with low-dose computed tomography," said the reporter. author Sam Hanash, co-author of the study. , MD, Ph.D., Professor of Clinical Cancer Prevention at the MD Anderson Cancer Center at the University of Texas

The biomarker panel has attained higher sensitivity – identifying smokers who subsequently developed bad cancer. lung – without increasing false positives for screening approved by the US Preventive Service Task Force (USPSTF) for heavy smokers based on age and history of smoking.

USPSTF guidelines only in adults 55 to 80 years old with a smoking history of 30 packets who have been smoking for 15 years.

"The biomarker panel specifically identifies at-risk smokers who need to be screened, even though they are not at higher risk based solely on the history of smoking," Hanash said. "A positive blood test means that a smoker is as much, if not more, at risk of having lung cancer than a fat smoker with a low biomarker score."

The article reports a validation study of the biomarker model in 63 patients who had already developed lung cancer in the year following the first blood collection compared to 90 matched controls in two large European cohorts of population.

The researchers compared a model based on the history of smoking to an integrated model including the biomarker score based on the four most past smoking markers.

At the same level of false positive rate (specificity) established by the USPSTF guidelines, the integrated test with biomarkers identified 63 percent of future lung cancer cases (40 out of 63). Improved detection, Hanash said, reflects the ability of the biomarker group to identify people at risk among the larger population of smokers. In the validation study, the history of smoking did not improve the prediction of future lung cancer cases beyond those provided by biomarkers alone.

The Hanash Group worked with European researchers affiliated with the International Agency for Research on Cancer. Health Organization The main co-authors were Mattias Johansson, Ph.D., IARC and Paul Brennan, Ph.D., Head of the IARC Genetics Section.

MD Anderson's Lung Cancer Moon Shot ^™ part of the institution's Moon Shots program ^™ provided initial support for Hanash's research, primarily through funding from the Lyda Hill Foundation.

Prediagnosis of blood sampling was crucial
Biomarker screening was the availability of blood samples taken from people before they developed the disease. This contrasts with most previous studies comparing biomarkers in patients with early-stage lung cancer to healthy controls. Such studies do not reflect how biomarkers can help predict future cancers.

To develop the biomarker blood test, the Hanash Group conducted the badysis of blood samples taken from 108 former smokers who were diagnosed with lung cancer. compared to 216 matched controls. All participated in the Caretene and Retinol Efficacy Trial (CARET), a lung cancer prevention trial conducted in North America in the 1990s.

"We compared smokers with lung cancer to smokers who did not smoke." 39 had no lung cancer. there are differences in biomarkers between these groups, so it was not just the smoking status that gave us differences, "Hanash said. "Then we compared the cancer cases to the general population and found similar differences."

The resulting panel comprises four proteins found in blood:

• The Precursor Form of Protein B Surfactant (Pro-SFTPB)
• 125 (CA125)
• Fragment of Cytokeratin-19 (CYFRA 21-1)
• Carcinoembryonic Antigen (CEA)

The validation study was conducted in patients of the European prospective survey on cancer and nutrition and disease study.

The researchers note that their results need to be validated in larger studies to validate and refine the predictive model based on biomarkers. Hanash said it will depend on the guidelines of the US Food and Drug Administration (FDA), and consultations with the FDA have begun.

Lung cancer causes about 20-25 percent of cancer deaths – 1.69 million a year worldwide. 155,000 in the United States. Early detection improves the chances of survival, but most countries do not screen for the disease and it is estimated that less than half of all US cases are among those eligible under the USPSTF guidelines.