Madrid, 16 November 2023. - After 5 years of monitoring smoker volunteers, researchers from the Moonshot observational study have developed a four-protein biomarker in blood with a prospective validation that has demonstrated a significant improvement in the capacity to identify individuals with a higher risk of developing lung cancer. The aim of this biomarker is to facilitate the access of these people to the detection program via a low radiation CT scan and will be available soon, enabling the selection of the individuals most susceptible to lung cancer with greater precision than the methods used until now.
Lung cancer is the principal cause of cancer related deaths worldwide, and its mortality rate is the highest in both men and women2. However, despite the low global survival rates in non-small-cell lung cancer (NSCLC), up to 80%1 of patients can survive for up to 10 years with early detection (stage I), making it necessary to develop new screening programs.
For this purpose, the Moonshot lung cancer program was established, led by MD Anderson Houston with the participation of MD Anderson Madrid. The program, focused on establishing a panel of blood biomarkers for the early detection of this type of tumours in smokers or ex-smokers, recruited 10,000 volunteers on whom an annual spirometry, low dose chest CT scan and blood analysis were performed. Spain participated in this five-year worldwide study along with the USA, Canada, China and France. In addition, this study represented the establishment of the first early detection protocol for this disease in our country.
New demographic criteria to improve the results in lung cancer testing
Two published studies highlighted the importance of implementing annual testing programs using low radiation CT scans on smokers, concluding that those who periodically undertook this type of test experienced a 20% reduction in mortality from lung cancer3,4, as the tumours were diagnosed in earlier stages.
Less than 15 years ago, countries such as the USA, Canada or the UK established annual screening programs using low radiation CT scans directed at smokers or ex-smokers between 50-80 years of age. “These demographic check-up programs do offer enormous benefits compared with an absence of diagnostic tests. However, there can be unwanted consequences to the performance of a low radiation CT scan”, indicated Natalia Carballo, Head of the Radiation Oncology Department and principal researcher of the Moonshot project in Spain. “Approximately 25% of the participants exhibited positive results, meaning there were findings related to a possible lung cancer. However, following an additional assessment, it was determined that 96% of the volunteers did not actually have a pathology”, added the specialist.
As a result, it was clear that, in spite of the validity of the screening using low radiation CT scans, new demographic criteria are necessary to improve the results. “One of the ways of obtaining more precise results for a demographic check program would be to combine them with blood biomarkers which would enable us to select the individuals at the most risk”, explained Carballo.
A worldwide initiative in the fight against cancer
This ambitious objective of obtaining predictive biomarkers is a project that has enjoyed international support since 2016 when the then Vice-president of the USA, Joe Biden, announced the launch of Moonshot, a worldwide program with a clear goal - namely to overcome cancer. For this purpose, he set up 13 separate initiatives, each devoted to a distinct tumour, involving different countries, races and nationalities, with the aim of creating a reliable map of the disease.
Given its experience and reputation in cancer treatment, MD Anderson Houston was entrusted with leading the research into lung cancer, the tumour with the highest incidence and mortality rate in the world2. Due to this and the fact that Spain, despite the reduction in tobacco use over recent years, is still one of the European countries where the most tobacco is consumed (latest estimates from Eurostat suggest that 19.7% of the Spanish smoke5), MD Anderson Cancer Center Madrid is one of the centres involved in the Moonshot lung cancer program.
References:
- Deval, J. C., Benito, M. B., Cuesta, J. C. P., Pérez, E. M., Contreras, S. S., Mojarrieta, J. C., De Aguiar Quevedo, K., Martínez, M. A., & Arana, E. (2022). Cribado de cáncer de pulmón: supervivencia en un amplio programa de detección precoz en España (I-ELCAP). Archivos de Bronconeumología, 58(5), 406-411. https://doi.org/10.1016/j.arbres.2021.10.005
- World Health Organization: WHO & World Health Organization: WHO. Cáncer de pulmón. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/lung-cancer#:~:text=El%20c%C3%A1ncer%20de%20pulm%C3%B3n%20es,85%25%20de%20todos%20los%20casos Último acceso: noviembre 2023.
- Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. NEJM; 355:395-409
- Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial Harry J. de Koning, et al. NEJM 2020. 382:503-513
- Product - Products Datasets - Eurostat. (s. f.). Eurostat. Disponible en: https://ec.europa.eu/eurostat/web/products-datasets/-/hlth_ehis_sk3i. Último acceso: noviembre 2023.