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Joseph Berei



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    P1 - Poster Viewing (ID 5)

    • Event: NACLC 2019
    • Type: Poster Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 10/11/2019, 16:45 - 18:00, Exhibit Hall
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      P1.19 - Lung Cancer Screening Initiative and Identification of Novel Blood Biomarkers for Early Detection of Lung Cancer   (ID 77)

      16:45 - 18:00  |  Author(s): Joseph Berei

      • Abstract

      Background:
      In lung cancer, 81% of patients are detected in late-stages, with early-stage cases generally presenting as asymptomatic. The age-adjusted lung cancer mortality rate in Winnebago County is 24.6% higher (2017) compared to the national rate; hence, to improve early detection of lung cancer in Winnebago County, we implemented low-dose computed tomography (LDCT) screening. Currently, LDCT is used to detect lung cancer at early-stages, and the CDC has proposed new guidelines for early screening in individuals between 55-77 years of age with a 30 pack/year smoking history. Additionally, early detection rates could be increased by using circulating DNA from lung cancer patients as well as examining changes in methylation patterns in genes that are expressed in lung cancer patients. Epidermal growth factor receptor (EGFR) is shown to be expressed in lung cancer patients’ serum in all stages; hence, it can be used as a potential biomarker for early detection.


      Method:
      To improve lung cancer early detection, we educated physicians about LDCT, evaluated the number of LDCTs performed, and recorded the lung cancer cases detected in Winnebago County. Additionally, patient blood samples were collected and then plasma was separated from whole blood. Circulating DNA was extracted from the plasma with the MagMax cell-free circulating kit and bisulfite converted. Identification of percent methylation patterns in the EGFR promoter region in CpG islands was obtained through completing next generation sequencing (NGS) followed by bioinformatics analysis.


      Results:
      In our study, 2,076 LDCT screenings occurred from June 2015 - March 2019 in Winnebago County. Lung cancer was diagnosed in 28 patients, out of which 17 patients were early-stage patients. We observed that 1.35% of patients screened in our study were diagnosed with lung cancer, compared to 0.87% of patients in the National Lung Cancer Screening Trial (NLCST), which may be due to the higher incidence of smoking in Winnebago County (18%) compared to the nation (15.5%). Our NGS analysis showed that in the promoter region of EGFR there are regions of hypermethylation (66.88-96.12%) in three CpG islands in sequences at the beginning of the promoter (-663 to -826 bases proximal to the ATG site in the promoter). However, there was hypomethylation (5.53-25.84%) at four CpG islands further downstream (-1019 to -1043 bases distal to the ATG site in the promoter).


      Conclusion:
      Currently, we are studying the methylation patterns in normal subjects to determine whether these regions could be used as predictive biomarkers for early detection.