scholarly journals Serum Metabolite Profiles in Participants of Lung Cancer Screening Study; Comparison of Two Independent Cohorts

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2714
Author(s):  
Piotr Widłak ◽  
Karol Jelonek ◽  
Agata Kurczyk ◽  
Joanna Żyła ◽  
Magdalena Sitkiewicz ◽  
...  

Serum metabolome is a promising source of molecular biomarkers that could support early detection of lung cancer in screening programs based on low-dose computed tomography. Several panels of metabolites that differentiate lung cancer patients and healthy individuals were reported, yet none of them were validated in the population at high-risk of developing cancer. Here we analyzed serum metabolome profiles in participants of two lung cancer screening studies: MOLTEST-BIS (Poland, n = 369) and SMAC-1 (Italy, n = 93). Three groups of screening participants were included: lung cancer patients, individuals with benign pulmonary nodules, and those without any lung alterations. Concentrations of about 400 metabolites (lipids, amino acids, and biogenic amines) were measured by a mass spectrometry-based approach. We observed a reduced level of lipids, in particular cholesteryl esters, in sera of cancer patients from both studies. Despite several specific compounds showing significant differences between cancer patients and healthy controls within each study, only a few cancer-related features were common when both cohorts were compared, which included a reduced concentration of lysophosphatidylcholine LPC (18:0). Moreover, serum metabolome profiles in both noncancer groups were similar, and differences between cancer patients and both groups of healthy participants were comparable. Large heterogeneity in levels of specific metabolites was observed, both within and between cohorts, which markedly impaired the accuracy of classification models: The overall AUC values of three-state classifiers were 0.60 and 0.51 for the test (MOLTEST) and validation (SMAC) cohorts, respectively. Therefore, a hypothetical metabolite-based biomarker for early detection of lung cancer would require adjustment to lifestyle-related confounding factors that putatively affect the composition of serum metabolome.

2018 ◽  
Vol 4 (3) ◽  
pp. 00001-2018 ◽  
Author(s):  
Tanel Laisaar ◽  
Bruno Sarana ◽  
Indrek Benno ◽  
Kaja-Triin Laisaar

Since publication of the National Lung Cancer Screening Trial (NLST) results early lung cancer detection has been widely studied, targeting individuals based on smoking history and age. However, over recent decades several changes in lung cancer epidemiology, including risk factors, have taken place. The aim of the current study was to explore smoking prevalence among lung cancer patients who had been treated surgically or undergone a diagnostic operation and whether these patients would have met the NLST inclusion criteria.All patients operated on for lung cancer in a university hospital in Estonia between 2009 and 2015 were included. Data were collected from hospital records.426 patients were operated on for lung cancer, with smoking history properly documented in 327 patients (87 females; median age 67 years). 170 (52%) patients were smokers, 97 (30%) patients were ex-smokers and 60 (18%) patients were nonsmokers. The proportion of females among smokers was 15%, among ex-smokers was 9% and among nonsmokers was 87%. 107 of our patients would not have met the NLST age criteria and 128 of our patients would not have met the NLST smoking criteria. In total, 183 patients (56% (79% of females and 48% of males)) would not have met the NLST inclusion criteria.Only half of surgically treated lung cancer patients were current smokers and more than half did not meet the NLST inclusion criteria.


F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 61 ◽  
Author(s):  
Melissa New ◽  
Robert Keith

Despite advances in targeted treatments, lung cancer remains a common and deadly malignancy, in part owing to its typical late presentation. Recent developments in lung cancer screening and ongoing efforts aimed at early detection, treatment, and prevention are promising areas to impact the mortality from lung cancer. In the past several years, lung cancer screening with low-dose chest computed tomography (CT) was shown to have mortality benefit, and lung cancer screening programs have been implemented in some clinical settings. Biomarkers for screening, diagnosis, and monitoring of response to therapy are under development. Prevention efforts aimed at smoking cessation are as crucial as ever, and there have been encouraging findings in recent clinical trials of lung cancer chemoprevention. Here we review advancements in the field of lung cancer prevention and early malignancy and discuss future directions that we believe will result in a reduction in the mortality from lung cancer.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13572-e13572
Author(s):  
Carol Velez Martinez ◽  
Aswani Thurlapati ◽  
Samina Hirani ◽  
Constance Larea Cole ◽  
Jade Abad ◽  
...  

e13572 Background: Lung cancer is the leading cause of cancer related deaths in men and women with 1.76 million deaths worldwide in 2018 [1]. Given its high prevalence and mortality, trials were developed to improve screening strategies. National-Lung-Screening-Trial showed a 20% relative-risk-reduction in mortality in people screened with annual low-dose-CT-scan [2] leading to the implementation of current USPSTF guidelines. We used USPSTF screening criteria to estimate the proportion of non-small cell lung cancer (NSCLC) patients that would have been screening-eligible at our institution.Upon chart review 33% of overall lung cancer patients at our institution did not meet the screening guidelines. We decided to investigate the need to modify the current screening guidelines of our institution based on individual risk assessment. Methods: We conducted a retrospective observational cohort study of the new diagnoses at Louisiana-State-University-Shreveport from 2011-2015. Patients were categorized into high-risk (groups 1 and 2), moderate risk, and low risk according to 2018 NCCN Lung Cancer Screening Guidelines Version 1.2020 [3]. To differentiate between high-risk group 2 and moderate risk, the Tammemagi lung cancer risk calculator was employed, considering 1.3% threshold of lung cancer risk over 6-year time frame [4]. According to NCCN, high-risk group 1 and 2 are eligible for annual low-dose-CT-scan. Results: 33% of overall lung cancer patients at our institution did not meet the screening guidelines criteria, among the 33% ineligible for screening, only 12.5% fell under the high-risk category based on the Tammemagi calculator. Conclusions: Despite using individual risk assessment based on Tammemagi calculator, 87.5% of lung cancer patients ineligible to current USPSTF guidelines are still missing the eligibility for screening at our institution. We believe more efficient risk prediction models have to be developed to improve selection of individuals for lung cancer screening.


Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3414
Author(s):  
Mateusz Smolarz ◽  
Agata Kurczyk ◽  
Karol Jelonek ◽  
Joanna Żyła ◽  
Łukasz Mielańczyk ◽  
...  

Molecular components of exosomes and other classes of small extracellular vesicles (sEV) present in human biofluids are potential biomarkers with possible applicability in the early detection of lung cancer. Here, we compared the lipid profiles of serum-derived sEV from three groups of lung cancer screening participants: individuals without pulmonary alterations, individuals with benign lung nodules, and patients with screening-detected lung cancer (81 individuals in each group). Extracellular vesicles and particles were purified from serum by size-exclusion chromatography, and a fraction enriched in sEV and depleted of low-density lipoproteins (LDLs) was selected (similar sized vesicles was observed in all groups: 70–100 nm). The targeted mass-spectrometry-based approach enabled the detection of 352 lipids, including 201 compounds used in quantitative analyses. A few compounds, exemplified by Cer(42:1), i.e., a ceramide whose increased plasma/serum level was reported in different pathological conditions, were upregulated in vesicles from cancer patients. On the other hand, the contribution of phosphatidylcholines with poly-unsaturated acyl chains was reduced in vesicles from lung cancer patients. Cancer-related features detected in serum-derived sEV were different than those of the corresponding whole serum. A high heterogeneity of lipid profiles of sEV was observed, which markedly impaired the performance of classification models based on specific compounds (the three-state classifiers showed an average AUC = 0.65 and 0.58 in the training and test subsets, respectively).


Author(s):  
Christopher J Cadham ◽  
Pianpian Cao ◽  
Jinani Jayasekera ◽  
Kathryn L Taylor ◽  
David T Levy ◽  
...  

Abstract Background Guidelines recommend offering cessation interventions to smokers eligible for lung cancer screening, but there is little data comparing specific cessation approaches in this setting. We compared the benefits and costs of different smoking cessation interventions to help screening programs select specific cessation approaches. Methods We conducted a societal-perspective cost-effectiveness analysis using a Cancer Intervention and Surveillance Modeling Network model simulating individuals born in 1960 over their lifetimes. Model inputs were derived from Medicare, national cancer registries, published studies, and micro-costing of cessation interventions. We modeled annual lung cancer screening following 2014 US Preventive Services Task Force guidelines plus cessation interventions offered to current smokers at first screen, including pharmacotherapy only or pharmacotherapy with electronic and/or web-based, telephone, individual, or group counseling. Outcomes included lung cancer cases and deaths, life-years saved, quality-adjusted life-years (QALYs) saved, costs, and incremental cost-effectiveness ratios. Results Compared with screening alone, all cessation interventions decreased cases of and deaths from lung cancer. Compared incrementally, efficient cessation strategies included pharmacotherapy with either web-based cessation ($555 per QALY), telephone counseling ($7562 per QALY), or individual counseling ($35 531 per QALY). Cessation interventions continued to have costs per QALY well below accepted willingness to pay thresholds even with the lowest intervention effects and was more cost-effective in cohorts with higher smoking prevalence. Conclusion All smoking cessation interventions delivered with lung cancer screening are likely to provide benefits at reasonable costs. Because the differences between approaches were small, the choice of intervention should be guided by practical concerns such as staff training and availability.


Sign in / Sign up

Export Citation Format

Share Document