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Zhu W, Love K, Gray SW, Raz DJ. Liquid Biopsy Screening for Early Detection of Lung Cancer: Current State and Future Directions. Clin Lung Cancer 2023; 24:209-217. [PMID: 36797152 DOI: 10.1016/j.cllc.2023.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/06/2023] [Accepted: 01/17/2023] [Indexed: 01/28/2023]
Abstract
Liquid biopsy (LB) is clinically utilized to detect minute amounts of genetic material or protein shed by cancer cells, most commonly cell free DNA (cfDNA), as a noninvasive precision oncology tool to assess genomic alterations to guide cancer therapy or to detect the persistence of tumor cells after therapy. LB is also being developed as a multi-cancer screening assay. The use of LB holds great promise as a tool to detect lung cancer early. Although lung cancer screening (LCS) with low-dose computed tomography (LDCT) substantially reduces lung cancer mortality in high-risk individuals, the ability of current LCS guidelines to reduce the public health burden of advanced lung cancer through early detection has been limited. LB may be an important tool to improve early lung cancer detection among all populations at risk for lung cancer. In this systematic review, we summarize the test characteristics, including sensitivity and specificity of individual tests, as they pertain to the detection of lung cancer. We also address critical questions in the use of liquid biopsy for early detection of lung cancer including: 1. How might liquid biopsy be used to detect lung cancer early; 2. How accurate is liquid biopsy in detecting lung cancer early; and 3. Does liquid biopsy perform as well in never and light-smokers compared with current and former smokers.
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Affiliation(s)
- William Zhu
- Department of Surgery, City of Hope, Duarte, CA
| | - Kyra Love
- Library Services, City of Hope, Duarte, CA
| | - Stacy W Gray
- Department of Medical Oncology and Therapeutics Research/ Department of Population Sciences, City of Hope, Duarte, CA
| | - Dan J Raz
- Department of Surgery, City of Hope, Duarte, CA.
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Shai S, Patolsky F, Drori H, Scheinman EJ, Davidovits E, Davidovits G, Tirman S, Arber N, Katz A, Adir Y. A novel, accurate, and non-invasive liquid biopsy test to measure cellular immune responses as a tool to diagnose early-stage lung cancer: a clinical trials study. Respir Res 2023; 24:52. [PMID: 36788537 PMCID: PMC9927051 DOI: 10.1186/s12931-023-02358-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/05/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Lung cancer remains the leading cause of death from cancer, worldwide. Developing early detection diagnostic methods, especially non-invasive methods, is a critical component to raising the overall survival rate and prognosis for lung cancer. The purpose of this study is to evaluate two protocols of a novel in vitro cellular immune response test to detect lung cancer. The test specifically quantifies the glycolysis metabolism pathway, which is a biomarker for the activation level of immune cells. It summarizes the results of two clinical trials, where each deploys a different protocol's version of this test for the detection of lung cancer. In the later clinical trial, an improved test protocol is applied. METHOD The test platform is based on changes in the metabolic pathways of the immune cells following their activation by antigenic stimuli associated with Lung cancer. Peripheral Blood Mononuclear Cells are loaded on a multiwell plate together with various lung tumor associated antigens and a fluorescent probe that exhibits a pH-dependent absorption shift. The acidification process in the extracellular fluid is monitored by a commercial fluorescence plate reader device in continuous reading for 3 h at 37 °C to document the fluorescent signal received from each well. RESULTS In the later clinical trial, an improved test protocol was applied and resulted in increased test accuracy. Specificity of the test increased to 94.0% and test sensitivity increased to 97.3% in lung cancer stage I, by using the improved protocol. CONCLUSION The improved protocol of the novel cellular immune metabolic response based test detects stage I and stage II of lung cancer with high specificity and sensitivity, with low material costs and fast results.
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Affiliation(s)
- Shafrira Shai
- Savicell Diagnostics Ltd., Matam Advanced Technology Park, Building #23, P.O. Box 15050, 3190501, Haifa, Israel.
| | - Fernando Patolsky
- grid.12136.370000 0004 1937 0546School of Chemistry, Faculty of Exact Sciences, Tel Aviv University, 69978 Tel Aviv, Israel
| | - Hagai Drori
- Savicell Diagnostics Ltd., Matam Advanced Technology Park, Building #23, P.O. Box 15050, 3190501 Haifa, Israel
| | - Eyal J. Scheinman
- Savicell Diagnostics Ltd., Matam Advanced Technology Park, Building #23, P.O. Box 15050, 3190501 Haifa, Israel
| | - Eyal Davidovits
- Savicell Diagnostics Ltd., Matam Advanced Technology Park, Building #23, P.O. Box 15050, 3190501 Haifa, Israel
| | - Giora Davidovits
- Savicell Diagnostics Ltd., Matam Advanced Technology Park, Building #23, P.O. Box 15050, 3190501 Haifa, Israel
| | - Shoval Tirman
- Savicell Diagnostics Ltd., Matam Advanced Technology Park, Building #23, P.O. Box 15050, 3190501 Haifa, Israel
| | - Nadir Arber
- grid.413449.f0000 0001 0518 6922Integrated Cancer Prevention Center, Tel Aviv Sourasky Medical Center, 6 Weizmann St., 6423906 Tel Aviv, Israel
| | - Amit Katz
- grid.413731.30000 0000 9950 8111Department of General Thoracic Surgery, Rambam Health Care Campus, 8 HaAliya HaShniya St., PO Box 9602, 31096 Haifa, Israel
| | - Yochai Adir
- grid.413469.dPulmonary Division, Faculty of Medicine, Lady Davis Carmel Medical Center, Mikhal Street 7, 3436212 Haifa, Israel
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