Potential Biomarkers May Identify Lung Cancer Type, Stage, Survival Likelihood

Researchers have identified biomarkers from blood samples and tumor tissues of patients with non-small lung cancer (NSCLC) that can distinguish between major subtypes of the disease and accurately identify lung cancer stage, according to a new study published in Scientific Reports.
Low-dose CT screening for lung cancer is effective at detecting tumors; however, the cost of this screening and the associated risks of radiation exposure indicate a need to better identify individuals who will benefit the most. Currently, the US Preventive Services Task Force recommends that middle-age and older individuals with a history of heavy smoking be screened annually for lung cancer.
However, despite the efficacy of CT screening, its implementation is not feasible for the general population. With lung cancer as the leading cause of cancer-related death in the United States, there is a need for a low-cost and effective method of screening that can prompt patients to seek further evaluation. According to the study, the idea is to identify patients by blood sample who would then be referred for CT screening.
Using high-resolution magnetic resonance spectroscopy, the researchers studied paired blood samples and tumor tissues taken at the time of surgery to identify metabolomic markers. They examined specimens from 42 patients with squamous cell carcinomas (SCC) of the lung and 51 patients with adenocarcinomas of the lung, as well as blood samples from 29 healthy volunteers. Fifty-eight patients had early-stage lung cancer and 35 had more advanced disease.
Overall, the researchers identified specific profiles of metabolites common to both types of samples that can differentiate between cancer types SCC or adenocarcinoma, and can distinguish between early-stage disease and later disease stages.
Notably, the researchers also identified profiles that can predict a patient’s overall survival for all cases and, more importantly, for early-stage cases alone. The test accurately predicted whether blood samples came from patients with shorter or longer survival following lung cancer surgery, including for patients with early disease. Prolonged survival was associated with relative overexpression of glutamine, valine, and glycine, and relative suppression of glutamate and lipids in serum, according to the study.
This could potentially help to determine whether patients will require standard treatment or more aggressive therapy for their disease, the researchers noted. If further validated, the blood test could be used to identify those at high risk who might benefit from more advanced screening with CT.
“Success in these investigations can propel biomarkers towards clinical trials and towards the ultimate goal—to indicate cancer and screen patients to advanced radiological imaging when warranted,” the researchers concluded.
Berker Y, Vandergrift LA, Wagner I, et al. Magnetic Resonance spectroscopy-based metabolomic biomarkers for typing, staging, and survival estimation of early-stage human lung cancer. Scientific Reports. 2019.  https://www.nature.com/articles/s41598-019-46643-5#Sec7
Investigators identify potential markers of lung cancer in paired blood and tissue samples [news release]. Massachusetts General Hospital. https://www.massgeneral.org/about/pressrelease.aspx?id=2422. Accessed July 16, 2019.

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