Developing a Better Test for Lung Cancer

Through Lehigh Valley Topper Cancer Institute's partnership with the Memorial Sloan Kettering Cancer Alliance (MSK Cancer Alliance), individuals will soon have access to a clinical trial aiming to find better ways to detect lung cancer in current and former smokers.

The Composite Biomarker for Early Detection of Tobacco-Related Cancer Trial will recruit people who present for annual low-dose computed tomography (LDCT) scans. Individuals who enroll will provide blood, saliva and urine samples at the time of their scans. These samples will be analyzed with the aim of finding novel genetic markers that may signal the presence of cancer cells. They will be stored in a biospecimen bank to further future research on the smoking population.

Nearly 3,000 individuals undergo LDCT lung cancer screening exams annually at Lehigh Valley Health Network. Frank Sperrazza, DO, with Lehigh Valley Physician Group Family Medicine–Southside, helped formalize the program with outreach to patients and primary care providers in 2018.

“The program has been a great success in helping to detect multiple lung cancers at a treatable stage,” he says. He adds that advances in minimally invasive surgical techniques have enabled the removal of nodules in previously hard-to-reach areas with a high degree of accuracy; some individuals do not require follow-up chemotherapy and radiation.

The U.S. Preventive Services Task Force recommends annual LDCT screening for adults ages 50-80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.

About 200 patients throughout the network are expected to be recruited for the study. “Patients will be asked to come to Lehigh Valley Hospital (LVH)–Cedar Crest or LVH–Muhlenberg to get their LDCT scans and have their biospecimen collection on the same day,” says Morgan Horton, RN, Director of Oncology Research. Individuals will be followed for two years.

“The goal is to develop a biomarker test that would be easy to administer without exposing patients to radiation or requiring them to undergo any kind of procedure,” Sperrazza says.

The trial is part of the MSK Precision Interception and Prevention Program, which includes a number of initiatives to prevent cancer or detect and intercept it early.

“In many cases, lung cancer does not present with any symptoms until the disease is quite advanced,” Sperrazza says. “This trial is key to helping us find new methods for detecting it, perhaps even before it’s visible on a LDCT scan. This is one more example of how the MSK Cancer Alliance is helping us gain access to key clinical trials and treatments and how vital this partnership is to our community.”

“To be eligible for screening, patients need to have an extensive smoking history,” says pulmonologist C. Gerard Petersen, MD, with LVPG Pulmonary and Critical Care Medicine. “Along with being the biggest risk factor for lung cancer, smoking is one of the top risk factors for coronary artery disease. That’s why it isn’t surprising to find atherosclerosis in individuals who get screened.”

Individuals must meet all of the following criteria to receive a lung cancer screening:

• Be age 50-80
• Have a 20 pack-year smoking history (determined by multiplying the number of cigarette packs smoked per day by the number of years smoked)
• Currently smoke or have quit within the past 15 years