Comprehensive evaluation of promising biomarkers for lung cancer risk prediction

Mattias JOHANSSON, International Agency for Research on Cancer, France
PENG L. 1 , AYUMU T. 2 , DAVID M. 3 , SAMIR H. 2 , BRENNAN P. 1

1 International Agency for Research on Cancer
2 University of Texas MD Anderson Cancer Center
3 Imperial College, London, United Kingdom

Background
Lung cancer will remain the number one cancer killer worldwide for the foreseeable future (Globocan 2012).  Although low-dose CT screening has been shown to reduce mortality, there is an urgent need to improve risk prediction models to identify those subjects at high risk and most likely to benefit from screening in order its improve the screening efficacy (PMID: 23697514, 25372087).
Methods
We have assembled a panel of promising blood-based risk biomarkers for lung cancer that are currently being validated in two large prospective cohorts (EPIC and NSHDS) in order to identify a set of validated risk markers for use in lung cancer risk assessment. Biospecimens from these cohorts include pre-diagnostic plasma from 550 former and current smoking lung cancer cases that were diagnosed within 5 years of blood draw, along with 1,100 matched controls.
Results
Preliminary data indicate that blood-based biomarkers of lung cancer risk have a strong potential to improve on questionnaire-based risk prediction models for lung cancer (PMID: 26282655). In particular, based on a panel of 18 markers analyzed in the NSHDS study, we selected the 4 most risk informative markers and observed c-statistics of 0.80 using smoking history information alone, and 0.91 after incorporating additional the additional 4 risk markers. During the meeting we will present detailed results of the individual risk biomarkers and their associations with lung cancer risk up to 2 years prior to diagnosis, as well as an assessment of the extent to which they can improve traditional risk prediction models.