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Luis M Montuenga



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    PL05 - Affordable and Accessible Lung Cancer Care (Japanese, Mandarin, Spanish Translation Available) (ID 146)

    • Event: WCLC 2020
    • Type: Plenary
    • Track: N.A.
    • Presentations: 1
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      PL05.06 - Non-Invasive Biomarkers in Lung Cancer Screening: Achievements, Promises and Challenges (ID 3931)

      18:00 - 20:00  |  Presenting Author(s): Luis M Montuenga

      • Abstract
      • Slides

      Abstract

      LDCT-based lung cancer screening efficacy for the reduction of lung cancer deaths at the population level is now an evidence-based reality. The initial seminal papers published by the I-ELCAP consortium showing their data in their non-observational trial and the NLST and NELSON randomized trials have clearly shown the efficacy of this lung cancer early detection strategy in high risk individuals. Nevertheless, there are still limited numbers of lung cancer screening programs worldwide, considering the at-risk population1. The present talk will summarize the potential role of biomarkers to increase the efficacy of LDCT-based lung cancer screening. Biomarkers may improve the effectiveness of screening by (a) refining the selection of persons for screening; (b) providing data indicating whether indeterminate screening-detected nodules are of high or lower risk; and (c) predicting outcome or response to therapy, once a lung cancer has been diagnosed 2. I will summarize some of the available biomarkers that have been developed in the context of lung cancer screening3. I will stress on the need of rigorous and statistically sound validation for clinical utility4 and will present some examples of recently developed biomarkers, one of which is a circulating protein panel, on which we are currently working, which includes complement activation related fragments5. I will also mention an example of affordable prognostic marker for early lung cancer, developed in our lab, based on immune-localization of very few proteins6,7. Finally, I will focus on several recently published technologies of circulating DNA deep sequencing, which pursue highly specific and sensitive non-invasive early detection of either lung cancer or of multiple types of cancer: pan-cancer ctDNA analysis in liquid biopsy8-12. I will comment of the advantages and drawbacks of these highly sophisticated novel technologies from the point of view of affordability and cost-effectiveness.

      (1) Oudkerk et al Nat Rev Clin Oncol, 2020, October 12; (2)Veronese et al Cancers, 2020; 12: 1672;(3) Seijo et al J Thoracic Oncol, 2019; 14:343; (4) Mazzone et al. ATS oficial statement Am J Respir Crit Care Med, 2017; 196: e15; (5) Ajona, Pio et al: in revision; (6) Martinez-Terroba et al J Pathol, 2018; 245:421; (7) Martinez-Terroba et al Thorax, 2019; 74:371;(8) Chabon et al Nature, 2020; 580: 245; (9) Beer TM Am J Manag Care, 2020; 26:S292; (10) Cristiano et al Nature 2019; 570:385; (11) Lennon AM et al Science, 2020; 369:6499; (12) Liu et al Ann Oncol, 2020; 31:745.

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