Circulating Biomarkers for Early Stage Non-Small Cell Lung Carcinoma Detection: Supplementation to Low-Dose Computed Tomography

Chin Fung Kelvin Kan; Graham D Unis; Luke Z Li; Susan Gunn; Li Li; H Peter Soyer; Mitchell S Stark

doi:10.3389/fonc.2021.555331

Circulating Biomarkers for Early Stage Non-Small Cell Lung Carcinoma Detection: Supplementation to Low-Dose Computed Tomography

Front Oncol. 2021 Apr 21:11:555331. doi: 10.3389/fonc.2021.555331. eCollection 2021.

Authors

Chin Fung Kelvin Kan^{1

2

3}, Graham D Unis^{1

4}, Luke Z Li^{1

5}, Susan Gunn^{1

6}, Li Li¹, H Peter Soyer^{2

7}, Mitchell S Stark²

Affiliations

¹ The University of Queensland, Ochsner Clinical School, Laboratory of Translational Cancer Research, Ochsner Clinic Foundation, New Orleans, LA, United States.
² The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, QLD, Australia.
³ Department of General Surgery, Brigham and Women's Hospital, Boston, MA, United States.
⁴ Department of Medicine, Ochsner Clinic Foundation, New Orleans, LA, United States.
⁵ Department of Medicine, Stamford Hospital, Columbia College of Physicians and Surgeons, Stamford, CT, United States.
⁶ Department of Pulmonary and Critical Care, Ochsner Clinic Foundation, New Orleans, LA, United States.
⁷ Department of Dermatology, Princess Alexandra Hospital, Brisbane, QLD, Australia.

Abstract

Lung cancer is currently the leading cause of cancer death in both developing and developed countries. Given that lung cancer has poor prognosis in later stages, it is essential to achieve an early diagnosis to maximize patients' overall survival. Non-small cell lung cancer (NSCLC) is the most common form of primary lung cancer in both smokers and non-smokers. The current standard screening method, low-dose computed tomography (LDCT), is the only radiological method that demonstrates to have mortality benefits across multiple large randomized clinical trials (RCT). However, these RCTs also found LDCT to have a significant false positive rate that results in unnecessary invasive biopsies being performed. Due to the lack of both sensitive and specific screening methods for the early detection of lung cancer, there is an urgent need for alternative minimally or non-invasive biomarkers that may provide diagnostic, and/or prognostic information. This has led to the identification of circulating biomarkers that can be readily detectable in blood and have been extensively studied as prognosis markers. Circulating microRNA (miRNA) in particular has been investigated for these purposes as an augmentation to LDCT, or as direct diagnosis of lung cancer. There is, however, a lack of consensus across the studies on which miRNAs are the most clinically useful. Besides miRNA, other potential circulating biomarkers include circulating tumor cells (CTCs), circulating tumor DNA (ctDNAs) and non-coding RNAs (ncRNAs). In this review, we provide the current outlook of several of these biomarkers for the early diagnosis of NSCLC.

Keywords: biomarker; liquid biopsy; lung cancer; microRNA; non-small cell lung cancer; pulmonology.

Publication types

Review