By Lynda Williams, Senior medwireNews Reporter
The ability to screen for lung cancer is improved by the development of a plasma 24-microRNA signature classifier (MSC), research suggests.
During a median 27 months of follow-up, 69 of 939 patients screened had confirmed lung cancer. The MSC, which grades patients as being at low, intermediate or high risk of lung cancer on the basis of markers of tumour and aggressive disease, identified these cases with 87% sensitivity and 81% specificity.
By comparison, low dose computed tomography (LDCT) in this population was 79% sensitive and 81% specific for lung cancer, report Ugo Pastorino (Fondazi-one IRCCS Istituto Nazionale dei Tumori, Milan, Italy) and co-authors.
“The diagnostic characteristic of high [sensitivity] coupled with a [negative predictive value] of 99% indicates that MSC is a clinically useful screening test,” they write in the Journal of Clinical Oncology.
This was confirmed in a time dependency analysis which showed that the diagnostic values of the MSC were comparable at 6-, 12-, 18, and 24-month intervals to blood tests and lung cancer diagnosis.
Of the 652 patients who underwent LDCT and MSC screening, 58 were positive for both tests. The false-positive rate for lung cancer diagnosis was just 3.7% compared with a false-positive rate of 19.4% for patients undergoing LDCT screening alone.
Furthermore, MSC risk status was significantly associated with survival after adjusting for age and gender. All patients with a low MSC risk were alive 3 years after testing compared with 97% of those with an intermediate risk and 77% of those with a high risk.
“We report in this large validation study from the MILD trial the use of a robust [quantitative reverse transcriptase–polymerase chain reaction] assay of plasma-derived [MSCs] that has diagnostic performance for malignant disease presence, risk of future malignancy, and the ability to distinguish lung cancers from the majority of benign LDCT-detected pulmonary nodules,” Pastorino et al conclude.
“In a synergistic approach, MSCs could improve the effectiveness of LDCT for lung cancer screening by avoiding further rounds of LDCT in a large proportion of individuals and unnecessary invasive diagnostic follow-up.”
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