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PROBLEM:
Non‐small cell lung carcinoma is the leading cause of cancer mortality worldwide, largely due to a lack of effective tools for early diagnosis. Patients diagnosed with early stage disease (stage I) have a reasonably favourable prognosis (60–80% survival at 5 years). Unfortunately, only 20–25% of all NSCLCs are diagnosed early. Effective tools for the early detection of NSCLC, especially in high‐risk individuals (i.e. smokers), are critically needed to reduce diagnoses of advanced stage disease (stages III–IV) and lung cancer deaths. Several studies have reported the usefulness of LD‐CT, which is effective for the detection of nodules (even when these are small) and which can be used to diagnose asymptomatic lung cancers, most of which are at stage I. There is, however, concern regarding the feasibility of large‐scale population screening by LD‐CT: the technique is cumbersome, it requires specialized health centres, and the recruitment of at‐risk individuals with no signs of disease is difficult. A blood test, on the other hand, could be administered easily, would be fast and cheap, would not require specialized health centres and would encourage the recruitment of high‐risk individuals for the diagnostic anticipation of lung cancer.
RESULTS:
The authors developed a blood test for lung cancer diagnosis in asymptomatic high‐risk individuals (heavy smokers, aged over 50) based on the detection of miRNAs from serum. Sera were collected from high‐risk subjects enrolled in a large prospective early detection trial (the COSMOS study) for lung cancer by annual LD‐CT. A diagnostic signature of 34 serum miRNAs was identified. The signature can identify patients with early stage NSCLC with 80% overall accuracy. In addition, the signature can distinguish between benign lung nodules (which are a frequent occurrence in at‐risk individuals) and frank NSCLCs. Finally, the signature can capture the time of disease onset in individual patients over time.
IMPACT:
The authors report a blood test for the diagnosis of NSCLC of potential impact in the design of screening programmes for early detection in at‐risk individuals, with perspective improvement in the prognosis of the disease.
INTRODUCTION
Non‐small cell lung carcinoma (NSCLC) is the first cause of cancer mortality worldwide (Parkin et al, 2005), largely due to the lack of effective tools for early diagnosis. Patients diagnosed with early stage...