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Addition of Biomarker Panel to Lung Cancer Screening: Can It Improve Detection of Disease?

By: Sarah Campen, PharmD
Posted: Monday, August 20, 2018

Inclusion of a panel of circulating protein biomarkers into the smoking-exposure risk model seems to improve lung cancer risk assessment compared with risk based on age and smoking exposure alone, found researchers with the Integrative Analysis of Lung Cancer Etiology and Risk (INTEGRAL) Consortium for Early Detection of Lung Cancer. Samir M. Hanash, MD, PhD, of The University of Texas MD Anderson Cancer Center, and colleagues published their findings in JAMA Oncology.

“We observed a notable improvement in discrimination between future lung cancer cases and controls over a traditional smoking-based risk prediction model by incorporating information from a biomarker score consisting of 4 circulating proteins,” stated the study authors.

Researchers assessed prediagnostic samples from 108 ever-smoking patients with lung cancer diagnosed within 1 year after blood collection and samples from 216 smoking-matched controls to develop a biomarker risk score based on 4 proteins: cancer antigen 125, carcinoembryonic antigen, cytokeratin-19 fragment, and the precursor form of surfactant protein B. The biomarker score was then validated blindly using absolute risk estimates.

In comparison with the smoking model, the median 1-year risk estimates from the integrated risk prediction model increased for cases from 0.27% to 0.45% and decreased for controls from 0.12% to 0.04%. In the validation study, at an overall specificity of 0.83, the integrated risk prediction model yielded a higher sensitivity than the smoking model (0.63 vs. 0.43) and also yielded higher specificity at an overall sensitivity of 0.42 (0.95 vs. 0.86).

The integration of biomarker screening “may improve lung cancer risk assessment and may be used to define eligibility for computed tomography screening,” concluded Dr. Hanash and colleagues.



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