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James Jett



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    P2.11 - Screening and Early Detection (Not CME Accredited Session) (ID 960)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.11-10 - Potential Utility of a Positive EarlyCDT®-Lung Blood Biomarker Test in Indeterminate Pulmonary Nodules   (ID 14028)

      16:45 - 18:00  |  Presenting Author(s): James Jett

      • Abstract
      • Slides

      Background

      EarlyCDT®-Lung is a blood-based biomarker of risk for lung cancer and is able to detect early stage disease. Indeterminate pulmonary nodules (IPN) of 8-20 mm are a common clinical problem. Approximately 20% of IPNs are malignant in many series, but determining which ones are malignant versus benign is a dilemma. The ACCP guidelines recommend surgical resection for IPN of high risk for malignancy (>65%). A moderate positive EarlyCDT-Lung (sensitivity 40%; specificity 93%) has been shown to increase the risk of malignancy in IPNs of intermediate risk (10-65%) (Massion et al J Thorac Oncol 2017).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We evaluated 48 patients from a clinical audit with an IPN and a calculated risk of malignancy of >30% based on the Mayo/Swensen calculator.

      4c3880bb027f159e801041b1021e88e8 Result

      Twenty-five patients had benign nodules and 23 were proven to be lung cancer. The positive predictive value (PPV) of the calculator alone was 48%. The biomarker test was positive in 23% (11 of 48) of the population (>30% risk). Ten of these 11 were proven to be lung cancer and one was benign; PPV of 91%. This 9% rate for benign disease is a marked improvement from the average resection rate of 20-25% for benign disease that has been reported in multiple lung cancer screening trials (24% in NLST).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Combining the EarlyCDT-Lung blood test with calculated risk of IPNs of >30% resulted in a high PPV and would result in a resection rate of IPNs for benign disease of <10%. A prospective clinical utility study with EarlyCDT-Lung and IPNs is planned.

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