York E. Miller, MD, Professor of Medicine specializing in Pulmonary Sciences, and colleagues from the University of Colorado Denver have been awarded a research grant from LUNGevity Foundation to develop better predictive biomarkers for lung cancer patients.
Miller, who co-leads the Lung, Head and Neck Cancer Program at the University of Colorado Cancer Center, is collaborating on this project with Professor of Pathology Wilbur Franklin, MD, and Professor of Radiology-Diagnostics, Kavita Garg, MD. Other key investigators include Marileila Varella-Garcia, PhD; Rachel Ostroff, PhD; Anna Baron, PhD; and Holly Wolf, PhD, MSPH.
Only 16 percent of patients diagnosed with lung cancer survive five years after diagnosis. One reason for this is that, until recently, no early detection test for lung cancer had been validated. The National Lung Screening Trial recently demonstrated that computed tomography (CT) screening results in a 20 percent decrease in lung cancer mortality compared to chest radiographies. These findings suggest that CT scans will increasingly be used for lung cancer screening.
While CT scans detect lung nodules in 20-50 percent of patients, only 1-2 percent actually have lung cancer. Thus, CT scanning for lung cancer results in many false positive tests. Patients and physicians are often put in the situation of having to decide between serial CT scans to look for nodule enlargement (which takes months) or an immediate biopsy strategy. Each approach has potential drawbacks: serial observation can delay diagnosis, whereas an immediate biopsy strategy can pose unnecessary risk, infection and expense.
Biomarker-based testing for lung cancer is not yet available to patients, but it could help people make better decisions about their health.
“Many patients and physicians are faced with the quandary of ‘indeterminate’ lung nodules,” says Dr. Miller. “Improving these biomarker-based tests will help patients and physicians decide the best way to proceed.”
Miller and his team are working to improve two tests that have already shown promise in identifying patients at risk for lung cancer: analyzing chromosome numbers in sputum cells and identifying specific bioactive proteins in the blood. These will be combined with and compared to patient and CT image characteristics.
The team is improving the current sputum testing panel by developing two sub-panels with more disease specificity. One sub-panel would detect squamous cell carcinoma of the lung and the other would detect adenocarcinoma of the lung.
The bioactive protein test is being used as a springboard to develop separate tests for detecting specific lung cancer mutations (such as K-ras and EGFR) as well as specific types of lung cancer, including squamous cell and adenocarcinoma.
The investigators will then apply these tests to samples taken from lung cancer patients in order to validate their tests and testing procedures. In addition, the team will also analyze the patients’ corresponding CT scans to demonstrate the value of the tests and to assess the value of combining testing protocols.
By improving these promising testing techniques and conducting clinical testing on patient specimens, the investigators will confirm the importance of these biomarker-based tests. This work could revolutionize the options for patients who are in the process of determining whether they have lung cancer.