Lung cancer, the disease that claims the most lives (18 percent of all deaths from tumors), affects more than two million people worldwide each year.

Only about 12% of individuals who are affected live longer than 5 years, a terrible statistic that is clearly linked to the difficulty of detecting it in its early stages.

A new study published in the journal Clinical Oncology reveals a blood test together with a risk model based on an individual’s history can more precisely predict who is likely to benefit from lung cancer screening than the current U.S. recommendations.

A personalized lung cancer risk assessment that combined a blood test based on a four-marker protein panel developed at MD Anderson with an independent model (PLCOm2012) that takes smoking history into account was found to be more sensitive and specific than the US Preventive Services Task Force (USPSTF) criteria for 2021 and 2013.

Participants in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial having at least a 10-pack-year smoking history were included in the study. In comparison to the USPSTF criteria for 2021, the blood test plus model would have identified 9.2 percent more lung cancer cases for screening and reduced referral to screening among non-cases by 13.7 percent if applied.

“We recognize that a small percentage of people who are eligible for lung cancer screening through an annual low-dose CT scan are actually getting screening,” explains professor Sam Hanash, adding, “moreover, CT screening is not readily available in most countries. So, our goal, for many years, has been to develop a simple blood test that can be used first to determine need for screening and make screening for lung cancer that much more effective. Our study shows for the first time that a blood test could be useful to determine who may benefit from lung cancer screening.”

Hanash and colleagues created a blood test that included biomarkers that had previously been identified as lung cancer risk predictors. A multicenter team performed a blinded trial to assess the effectiveness of this four-protein marker panel in conjunction with the PLCOm2012 model, which was independently designed and validated to predict a six-year risk of lung cancer in people who smoke now or previously.

“When we began work on a blood test, there were many different types of markers,” Hanash adds. “We’ve done multiple analyses over the past decade to come up with a cost-effective test that’s simple, yet robust, which has been the guiding principle of our research.”

To validate the combination of blood indicators and the PLCOm2012 model, the researchers reviewed over 10,000 biospecimens from the PLCO trial, including 1,299 blood samples from 552 people who acquired lung cancer and 8,709 blood samples from 2,193 individuals who did not get lung cancer.

When compared to the current USPSTF criteria, the combined blood test with PLCOm2012 model demonstrated overall improved sensitivity (88.4 percent versus 78.5 percent) and specificity (56.2 percent versus 49.3 percent) among patients with at least a 10-pack-year smoking history. The combined individualized risk assessment, if adopted, would have identified 105 of the 119 participants in the PLCO intervention arm who were diagnosed with lung cancer within a year.

“A blood test would identify people who could benefit from lung cancer screening but are not eligible today,” Hanash adds. “Tens of millions of people worldwide could benefit from lung cancer screening. If you can improve screening eligibility by even 5%, that is incredibly impactful.”

While the blood test might be adopted as a lab-developed test in the near future, FDA approval would almost certainly require review in a prospective clinical study.

Source: doi.org/10.1200/JCO.21.01460

Image Credit: Getty

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