Blood-Based Biomarker Panel for Personalized Lung Cancer Risk Assessment.

Area of Science:

• Oncology
• Biomarker Discovery
• Preventive Medicine

Background:

• Lung cancer screening is crucial for early detection and improved survival rates.
• Current screening methods, like the USPSTF criteria, have limitations in sensitivity and specificity.
• Risk prediction models incorporating participant characteristics are used but can be further enhanced.

Purpose of the Study:

• To evaluate if a panel of circulating protein biomarkers improves lung cancer screening risk assessment.
• To assess the performance of a four-marker protein panel (4MP) combined with a risk model (PLCOm2012).
• To compare the combined model's effectiveness against existing US Preventive Services Task Force (USPSTF) screening criteria.

Main Methods:

• A blinded validation study utilized data and biospecimens from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.
• A four-marker protein panel (4MP) was analyzed in sera from lung cancer cases and non-cases.
• The performance of 4MP alone and in combination with the PLCOm2012 risk model was compared to USPSTF screening criteria.

Main Results:

• The four-marker protein panel (4MP) alone showed an area under the receiver operating characteristic curve (AUC) of 0.79 for recent cases.
• The combined 4MP + PLCOm2012 model achieved an AUC of 0.85 for recent cases, demonstrating improved sensitivity at high specificity.
• Compared to USPSTF2021 criteria, the combined model identified 9.2% more lung cancer cases and reduced referrals by 13.7% among non-cases in high-risk participants.

Conclusions:

• A blood-based biomarker panel, when integrated with the PLCOm2012 risk model, significantly enhances lung cancer risk assessment.
• This combined approach offers a more accurate and efficient strategy for lung cancer screening.
• The findings support the potential of blood biomarkers to refine current lung cancer screening protocols.