Blood-Based Biomarker Panel for Personalized Lung Cancer Risk Assessment.
Johannes F Fahrmann, Tracey Marsh, Ehsan Irajizad, Nikul Patel, Eunice Murage, Jody Vykoukal, Jennifer B Dennison, Kim-Anh Do, Edwin Ostrin, Margaret R Spitz, Stephen Lam, Sanjay Shete, Rafael Meza, Martin C Tammem��gi, Ziding Feng, Samir M Hanash
Author Information
Johannes F Fahrmann: Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX. ORCID
Tracey Marsh: Biostatistics Program, Fred Hutchinson Cancer Research Center, Seattle, WA. ORCID
Ehsan Irajizad: Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX.
Nikul Patel: Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX.
Eunice Murage: Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX. ORCID
Jody Vykoukal: Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX. ORCID
Jennifer B Dennison: Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX.
Kim-Anh Do: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
Edwin Ostrin: Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX. ORCID
Margaret R Spitz: Department of Medicine, Baylor College of Medicine, Houston, TX.
Stephen Lam: Department of Integrative Oncology, British Columbia Cancer Research Institute, Vancouver, British Columbia, Canada. ORCID
Sanjay Shete: Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Rafael Meza: Department of Epidemiology, University of Michigan, School of Public Health, Ann Arbor, MI. ORCID
Martin C Tammem��gi: Prevention and Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada. ORCID
Ziding Feng: Biostatistics Program, Fred Hutchinson Cancer Research Center, Seattle, WA.
Samir M Hanash: Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX. ORCID
PURPOSE: To investigate whether a panel of circulating protein biomarkers would improve risk assessment for lung cancer screening in combination with a risk model on the basis of participant characteristics. METHODS: A blinded validation study was performed using prostate lung colorectal ovarian (PLCO) Cancer Screening Trial data and biospecimens to evaluate the performance of a four-marker protein panel (4MP) consisting of the precursor form of surfactant protein B, cancer antigen 125, carcinoembryonic antigen, and cytokeratin-19 fragment in combination with a lung cancer risk prediction model (PLCO) compared with current US Preventive Services Task Force (USPSTF) screening criteria. The 4MP was assayed in 1,299 sera collected preceding lung cancer diagnosis and 8,709 noncase sera. RESULTS: The 4MP alone yielded an area under the receiver operating characteristic curve of 0.79 (95% CI, 0.77 to 0.82) for case sera collected within 1-year preceding diagnosis and 0.74 (95% CI, 0.72 to 0.76) among the entire specimen set. The combined 4MP + PLCO model yielded an area under the receiver operating characteristic curve of 0.85 (95% CI, 0.82 to 0.88) for case sera collected within 1 year preceding diagnosis. The benefit of the 4MP in the combined model resulted from improvement in sensitivity at high specificity. Compared with the USPSTF2021 criteria, the combined 4MP + PLCO model exhibited statistically significant improvements in sensitivity and specificity. Among PLCO participants with ��� 10 smoking pack-years, the 4MP + PLCO model would have identified for annual screening 9.2% more lung cancer cases and would have reduced referral by 13.7% among noncases compared with USPSTF2021 criteria. CONCLUSION: A blood-based biomarker panel in combination with PLCO significantly improves lung cancer risk assessment for lung cancer screening.
References
J Natl Cancer Inst. 2020 May 1;112(5):466-479
[PMID: 31566216]
