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Lung Cancer Early Detection: Canary Focuses on Non-Smokers

April 17, 2013

Recently, a story was published on KPLC 7 News noting how early detection is particularly difficult with lung cancer. In keeping with Canary Foundation’s two-step process, the Canary Early Cancer Detection for Lung Cancer program’s goal is to develop a combined blood test and imaging approach to detect lethal lung cancer early, because early detection and treatment greatly enhance survival.

“Oftentimes lung cancer symptoms like shortness of breath, coughing and wheezing are confused with conditions like asthma and pneumonia. That is why it is so important that those in the medical community know the next step for lung cancer diagnosis: Screenings.” (KPLC 7 News Online, “Early detection very difficult with lung cancer”)

The Canary Lung team is tackling the under-recognized area of lung cancer in non-smokers, seeking to understand why it develops and what the disease characteristics are in order to create screening tools for that disease.

Imaging for Lung Cancer Early Detection

CT screening* can reduce mortality from lung cancer, shown recently with the results of the National Lung Screening Trial, or NLST. Currently, when patients undergo a CT scan, it’s possible to see a problem spot, such as a lung nodule, but difficult to determine whether or not it is cancer. This presents a real opportunity to enhance the specificity of current imaging technology so it will be possible to determine if a spot isn’t or is cancer, and if so, whether it shows lethal characteristics.

Preliminary tests to improve the CT scan through molecular imaging have been very promising. A novel modified scan developed by Canary team members at Stanford uses new technologies to light up tumors so that their mass, and areas where they have spread, are clearly distinguishable in lung cancer patients. The technology will be tested for its specificity for early lung cancer (vs. benign conditions, such as scar tissue) in patients with lung nodules.

Biomarkers for Lung Cancer Early Detection

A blood biomarker test, used in combination with imaging, may also provide the specificity needed for accurate lung cancer screening. In line with Canary’s innovative and collaborative model, the Canary lung team has worked closely with five other organizations on a project to develop lung cancer biomarkers funded jointly by the National Cancer Institute (NCI). The most promising biomarkers from a comparison study in Vancouver are being selected.

The next step is to conduct a validation study of these biomarkers on carefully collected samples from the PLCO (Prostate, Lung, Colorectal, Ovarian) Screening Trial, a large randomized trial designed and sponsored by the NCI, to determine the effects of screening on cancer-related mortality.

If these biomarkers perform well on the PLCO samples, they will proceed through progressively more rigorous validation studies. Ultimately, blood biomarkers will be tested in combination with imaging in people currently getting screened for lung cancer, to validate the best approach for detecting lung cancer early and potentially saving lives.

*A computed tomography (CT) scan uses X-rays to make detailed pictures of structures inside the body.