Chemoprevention studies within lung cancer screening programmes

Area of Science:

• Oncology
• Pulmonology
• Radiology

Background:

• Lung cancer remains a leading cause of cancer death, necessitating novel prevention strategies beyond tobacco control.
• Low-dose computed tomography (LDCT) screening identifies high-risk individuals and detects precancerous lung nodules.
• Precancerous lesions, particularly peripheral subsolid nodules, are precursors to lung adenocarcinoma.

Purpose of the Study:

• To evaluate the potential of chemopreventive agents to induce regression of precancerous lung nodules detected by LDCT.
• To assess the efficacy of inhaled budesonide and aspirin in reducing lung nodule size.
• To investigate the impact of aspirin on a miRNA signature predictive of lung cancer and precancerous lesions.

Main Methods:

• A study involving high-risk individuals with indeterminate lung nodules detected via LDCT screening.
• Administration of inhaled budesonide versus placebo for 1 year, with 5-year follow-up.
• Initiation of a new randomized placebo-controlled phase-II trial investigating aspirin's effect on non-solid and partially solid nodules.
• Monitoring of a miRNA signature's response to aspirin in predicting cancer and precancerous lesions.

Main Results:

• Inhaled budesonide significantly reduced the mean size of non-solid lung nodules over 5 years compared to placebo.
• A new trial is evaluating aspirin's ability to induce regression of lung nodules detected by LDCT.
• The study will assess aspirin's effect on a miRNA signature previously shown to predict lung cancer and precancerous lesions.

Conclusions:

• Chemoprevention, using agents like budesonide, shows potential in regressing precancerous lung nodules identified through LDCT screening.
• Aspirin is being investigated as a potential chemopreventive agent for lung nodules.
• Monitoring miRNA signatures may aid in early detection and risk stratification for lung cancer in high-risk individuals.