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Blood Test May Spot Early Lung Cancer

Genetic Fingerprinting Predicts Which Smokers Could Go On to Develop Lung Cancer

Medically Reviewed by Louise Chang, MD on June 03, 2008
From the WebMD Archives

June 3, 2008 (Chicago) -- A simple blood test may be able to spot lung cancer in smokers long before symptoms develop, when there is still a chance of a cure, researchers report.

Lung cancer is the leading cancer killer, taking the lives of more than 160,000 Americans last year, according to the American Cancer Society. Nearly half of the cases are diagnosed at an advanced stage, when the cancer has spread to other parts of the body and is notoriously difficult to treat. Only about 15% of patients are alive five years after diagnosis. The vast majority of cases are caused by smoking.

But not every smoker develops lung cancer, says researcher Thomas Zander, MD, of the University Clinic Cologne, in Germany.

In an effort to weed out those at risk, Zander and colleagues identified a set of 154 genetic changes that distinguished 13 smokers who had lung cancer from 11 smokers who did not. Then, they validated the findings in another 35 smokers.

Next, the researchers looked for the genetic fingerprint in blood samples from 25,000 apparently healthy smokers in Germany.

The blood test was 80% accurate at predicting which of the smokers would go on to develop lung cancer in the next two years, he tells WebMD.

The findings were presented at the American Society of Clinical Oncology annual meeting.

Test Could Catch Lung Cancer Earlier

Zander says that detecting cancer earlier gives doctors a chance to step up screening efforts and possibly detect the cancer when it could still be cured with surgery, radiation, and/or chemotherapy.

"By two years later, it's too late," he tells WebMD.

Zander says that more studies are needed to validate the findings.

Other researchers were cautiously optimistic.

Julie Gralow, MD, head of ASCO's communications committee and a cancer researcher at the Fred Hutchinson Cancer Research Center in Seattle, says, "While very preliminary, this is a promising lead, an RNA fingerprint, in the form of a blood test, that if validated, will be used to predict lung cancer."

David M. Johnson, MD, deputy director of the Vanderbilt-Ingram Cancer Center in Nashville, says that researchers at Vanderbilt are testing a similar type of test, one designed to determine whether lung cancer patients will benefit from the targeted drug Avastin.

"The idea of all these personalized medicine studies is help us to better detect and select patient patients for treatment," he says.

Celebrex May Help Prevent Lung Cancer

Also at the meeting, researchers reported that the popular painkiller Celebrex may someday help to prevent lung cancer.

Celebrex lowered levels of a cancer biomarker called Ki-67 that is involved in cell proliferation, says study researcher Edward S. Kim, MD, an assistant professor of thoracic head and neck medical oncology at the University of Texas M.D. Anderson Cancer Center in Houston.

But, he stresses, the research is early and people shouldn't start popping Celebrex in hopes of warding off the disease.

This study involved 212 people, all of whom were current or previous heavy smokers. All had biopsies at the beginning of the study, and again three and six months later.

At the start, they were randomly assigned to take either Celebrex or a placebo for three months. Then they continued on the same treatment or crossed over to the other one for another three months.

At three months, people who took a higher, 400-milligram twice-daily dose of Celebrex had lower levels of Ki-67 than those who didn't. The lower 200-milligram twice-daily dose had no significant effect on levels Ki-67.

None of the people taking Celebrex developed cardiac problems, but the drug has been associated with an increased risk of heart attacks and other cardiovascular disease in other studies.

"We cannot say that taking [Celebrex] is going to prevent lung cancer," Kim says. "What we do know was that Celebrex, when taken over a three- or six-month period, was safe to administer even at a higher dose of 800 milligrams daily."

Kim tells WebMD that further research is needed to show that people with lower levels of Ki-67 actually have a lower risk of developing lung cancer.

Additional study is also needed to pinpoint which patients are at greatest risk for Celebrex-associated heart problems, he says. Then doctors could weigh the benefits and risks of the preventive therapy for each patient.

WebMD Health News

Sources

SOURCES:

American Society of Clinical Oncology 44th Annual Meeting, Chicago, May 30-June 2, 2008.

David M. Johnson, MD, deputy director, Vanderbilt-Ingram Cancer Center, Nashville.

Howard Sandler, MD, professor of radiation and oncology, University of Michigan, Ann Arbor.

Julie Gralow, MD, chairwoman, ASCO's communications committee; University of Washington, Seattle.

Edward S. Kim, MD, assistant professor of thoracic head and neck medical oncology, University of Texas M.D. Anderson Cancer Center, Houston.

American Cancer Society Cancer Facts & Figures.

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