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Low-dose computed tomography screening: circulating microRNA signature as liquid-biopsy to monitor lung cancer

Liquid biopsies can detect biomarkers carrying information on the development and progression of cancer. Researchers demonstrated that a 24 plasma-based microRNA signature classifier ( MSC ) was capable of increasing the specificity of low dose computed tomography ( LDCT ) in a lung cancer screening trial.

The prognostic performance of MSC, and its ability to monitor disease status recurrence in LDCT screening-detected lung cancers were tested.

Between 2000 and 2010, 3411 heavy smokers enrolled in two screening programmes, underwent annual or biennial LDCT.

During the first five years of screening, 84 lung cancer patients were classified according to one of the three MSC levels of risk: high, intermediate or low.

Follow-up MSC analysis was performed on longitudinal plasma samples ( n = 100 ) collected from 31 patients before and after surgical resection.

Five-year survival was 88.9% for low risk, 79.5% for intermediate risk and 40.1% for high risk MSC ( p = 0.001 ).

The prognostic power of MSC persisted after adjusting for tumor stage ( p = 0.02 ) and when the analysis was restricted to LDCT-detected cases after exclusion of interval cancers ( p less than 0.001 ).

The MSC risk level decreased after surgery in 76% of the 25 high-intermediate subjects who remained disease free, whereas in relapsing patients an increase of the MSC risk level was observed at the time of detection of second primary tumor or metastatic progression.

These results encourage exploiting the MSC test for lung cancer monitoring in LDCT screening. ( Xagena )

Sestini S et al, Oncotarget 2015;6:32868-32877