Blood-Based Biomarkers for Lung Cancer Screening: Proteins, miRNA, cfDNA, and Methylation Panels Reviewed
This Clinical Chemistry review evaluates blood-based biomarkers in clinical development for lung cancer screening, including protein panels, microRNAs, circulating cell-free DNA, and methylated DNA assays. The authors examine how these tests could improve risk stratification after nodule detection or optimise patient selection for LDCT screening. The review highlights the gap between promising analytical performance and the need for prospective clinical utility data in intended-use populations.
The original study
Emerging Strategies in Lung Cancer Screening: Blood and Beyond.
- Authors
- Bhalla S, Yi S, Gerber DE
- Journal
- Clinical chemistry
- Type
- Review, Journal Article, Research Support, Non-U.S. Gov't
- PMID
- 38175587
Original abstract
BACKGROUND: Although low dose computed tomography (LDCT)-based lung cancer screening (LCS) can decrease lung cancer-related mortality among high-risk individuals, it remains an imperfect and substantially underutilized process. LDCT-based LCS may result in false-positive findings, which can lead to invasive procedures and potential morbidity. Conversely, current guidelines may fail to capture at-risk individuals, particularly those from under-represented minority populations. To address these limitations, numerous biomarkers have emerged to complement LDCT and improve early lung cancer detection. CONTENT: This review focuses primarily on blood-based biomarkers, including protein, microRNAs, circulating DNA, and methylated DNA panels, in current clinical development for LCS. We also examine other emerging biomarkers-utilizing airway epithelia, exhaled breath, sputum, and urine-under investigation. We highlight challenges and limitations of biomarker testing, as well as recent strategies to integrate molecular strategies with imaging technologies. SUMMARY: Multiple biomarkers are under active investigation for LCS, either to improve risk-stratification after nodule detection or to optimize risk-based patient selection for LDCT-based screening. Results from ongoing and future clinical trials will elucidate the clinical utility of biomarkers in the LCS paradigm.