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Stuart Fraser
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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 | Author(s): Stuart Fraser
- Abstract
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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