In a study reported in the Journal of Clinical Oncology, Irajizad et al found that use of a blood-based four-marker protein panel (4MP)—together with the Prostate, Lung, Colorectal, and Ovarian (PLCOm2012) lung cancer risk model—was capable of identifying patients at high risk of lung cancer mortality.
Study Details
The study involved the assessment of 4MP and PLCOm2012 using prediagnostic sera from 552 patients with lung cancer and 2,193 noncases from the PLCO study cohort. PLCO participants were followed for an additional 13 years after the end of the 6-year PLCO study for lung cancer incidence and for 20 years for lung cancer death. The cumulative incidence of lung cancer death and subdistribution and cause-specific hazard ratios were calculated using 4MP plus PLCOm2012 risk scores at predefined 1.0% and 1.7% 6-year risk thresholds, corresponding to the 2021 and 2013 U.S. Preventive Services Task Force screening criteria.
Key Findings
Among the 552 patients diagnosed with lung cancer, 387 (70%) died from lung cancer. In an analysis including sera collected within 1 year preceding lung cancer diagnosis and all noncase sera, the 4MP plus PLCOm2012 model had a receiver operation characteristic area under the curve value of 0.88 (95% confidence interval [CI] = 0.86–0.90) for prediction of lung cancer–specific mortality.
In an analysis of the 1.7% 6-year risk threshold, the cumulative incidence of lung cancer death was significantly higher among patients with 4MP plus PLCOm2012 model test-positive scores (n = 805) vs test-negative patients (n = 1,253, P < .0001). Subdistribution and lung cancer death–specific hazard ratios were 12.82 (95% CI = 8.67–18.77) and 17.08 (95% CI = 9.61–10.64), respectively.
In an analysis of the 1.0% 6-year risk threshold, the cumulative incidence of lung cancer death was significantly higher among test-positive patients (n = 1,068) vs test-negative patients (n = 990, P < .001). Subdistribution and lung cancer death–specific hazard ratios were 9.88 (95% CI = 6.44–15.18) and 10.65 (95% CI = 6.93–16.37), respectively.
The investigators concluded, “The blood-based biomarker panel in combination with PLCOm2012 identifies individuals at high risk of a lethal lung cancer.”
Edwin Ostrin, MD, PhD, of The University of Texas MD Anderson Cancer Center, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the National Institutes of Health, National Cancer Institute, Cancer Prevention & Research Institute of Texas, and others. For full disclosures of the study authors, visit ascopubs.org.
