Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort

Authors

Ehsan Irajizad
Johannes F Fahrmann
Tracey Marsh
Jody Vykoukal
Jennifer B Dennison
James P Long
Kim-Anh Do
Ziding Feng
Samir Hanash
Edwin J Ostrin

Publication Date

9-20-2023

Journal

Journal of Clinical Oncology

Abstract

Purpose: To investigate the utility of integrating a panel of circulating protein biomarkers in combination with a risk model on the basis of subject characteristics to identify individuals at high risk of harboring a lethal lung cancer.

Methods: Data from an established logistic regression model that combines four-marker protein panel (4MP) together with the Prostate, Lung, Colorectal, and Ovarian (PLCO) risk model (PLCOm2012) assayed in prediagnostic sera from 552 lung cancer cases and 2,193 noncases from the PLCO cohort were used in this study. Of the 552 lung cancer cases, 387 (70%) died of lung cancer. Cumulative incidence of lung cancer death and subdistributional and cause-specific hazard ratios (HRs) were calculated on the basis of 4MP + PLCOm2012 risk scores at a predefined 1.0% and 1.7% 6-year risk thresholds, which correspond to the current and former US Preventive Services Task Force screening criteria, respectively.

Results: When considering cases diagnosed within 1 year of blood draw and all noncases, the area under receiver operation characteristics curve estimate of the 4MP + PLCOm2012 model for risk prediction of lung cancer death was 0.88 (95% CI, 0.86 to 0.90). The cumulative incidence of lung cancer death was statistically significantly higher in individuals with 4MP + PLCOm2012 scores above the 1.0% 6-year risk threshold (modified χ2, 166.27; P < .0001). Corresponding subdistributional and lung cancer death-specific HRs for test-positive cases were 9.88 (95% CI, 6.44 to 15.18) and 10.65 (95% CI, 6.93 to 16.37), respectively.

Conclusion: The blood-based biomarker panel in combination with PLCOm2012 identifies individuals at high risk of a lethal lung cancer.

Keywords

Male, Humans, Risk Assessment, Prostate, Lung Neoplasms, Lung, Biomarkers, Colorectal Neoplasms, Early Detection of Cancer

DOI

10.1200/JCO.22.02424

PMID

37379494

PMCID

PMC10522105

PubMedCentral® Posted Date

6-28-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes