Simple blood tests can reveal a great deal about a person's health. They can uncover infection, anemia, diabetes and high cholesterol and provide clues about many other conditions. What if a simple blood test also could help catch lung cancer early, when it's most treatable?
Researchers at Rush University Medical Center are trying to answer that question by working to develop a blood test for early detection of lung cancer. The National Institutes of Health awarded this endeavor a two-year $275,000 grant on January 1.
The availability of a rapid and accurate, non-invasive and inexpensive blood test could change early detection of lung cancer, which is often undiagnosed until symptoms become apparent in a more serious, advanced stage of the disease.
"Our goal is to improve the way lung cancer is diagnosed using a simple blood test to detect the disease earlier and reduce the number of late-stage diagnoses," said biochemist Jeffrey A. Borgia, PhD. "We are aiming to identify those who are at a higher risk by looking for a specific "signature" or biomarker in the blood.
"Currently there are screening guidelines for those who are at risk — people who have a history of smoking and are 55 to 80 years old — but what about a nonsmoking young person who gets lung cancer?" asked Borgia.
According to the American Cancer Society, as many as 20 percent of the people who die from lung cancer in the United States every year have never smoked or used any other form of tobacco. This translates to about 30,000 Americans in 2017.
Blood test would improve on and complement CT screenings
Currently, people at risk for lung cancer are advised to receive a low-dose computed tomography (CT) scan of their lungs to detect early-stage cancers.
"It is an effective screening tool, but most of the nodules we identify with CT scanning will turn out to be benign," said Dr. Christopher Seder, a thoracic surgeon at Rush. "We are trying to develop a better way to determine whether the nodule is malignant or not."
Also, while low-dose CT scanning currently is the best method for catching lung cancer early, the established guidelines for screening exclude many people who may still be diagnosed with the disease.
"The blood test ideally could be used as a detection method that will complement current CT imaging technology," said Borgia.
Biomarkers are key to cancer test
Cancer cells release a series of proteins into the bloodstream that are unique to the type of cancer, known as biomarkers.
Using one of the world's largest institutional repositories of blood and tissue samples from patients with benign and malignant thoracic tumors at Rush, Borgia's team has identified several biomarkers in the blood that may be able to identify non-small cell lung cancer with about 90 percent accuracy.
Thanks to the cell samples from patients — about 10 percent of whom fall outside current CT screening criteria — the team also is searching for biomarkers that could lead to a "prescreening" blood test designed to detect additional populations that might benefit from CT screening.
Rush University Medical Center has been on the leading edge of the lung cancer CT screening and lung cancer treatment. Rush is an American College of Radiology designated screening center as well as a Lung Cancer Alliance screening center of excellence.
Rush's preventive low-dose screening program, created in 2015, resulted in more than 3 percent cancer diagnoses found at earlier stages than when lung cancers are typically found. For these early-stage cancers, Dr. Michael Liptay and his thoracic surgical colleagues at Rush were able to perform minimally invasive procedures that gave these patients a better chance at survival.
The study was supported by the National Institutes of Health grant R21CA223335-01.