Abstract 882: Non-invasive diagnostic testing for lung cancer in a prospective cohort

Abstract

Abstract Monoclonal antibody Adnab-9 recognizes the p87 antigen, a constituent of putatively activated pulmonary type 2 pneumocytes. p87 shed into sputum and swallowed may be a potential tumor marker detectable by the Adnab-9 stool test. We describe prospectively collected stool and colonic effluent ELISA results in a cohort of urban patients enrolled in a colorectal cancer screening study. Methods: Prospectively, 1,132 American patients in Metropolitan Detroit submitted stool in a CRC prospective screening study from 1996 to 2013. Eleven patients free of any significant colorectal neoplasia or other cancer, but who had died from non-cancer-related causes, served as controls. Patients and controls were approximately 50-80 years old and the male to female ratios were similar (30:1 and 10:1). Sixty-seven percent of patients and 45 % of controls were African American. Results: 64 patients of 1,132 contracted lung cancer during the 17 year period of follow-up (5.7%). Of these 64 patients, 34 (52%) had stool or effluent Adnab-9 binding tests on retrospective review. We found that over half the patients ultimately diagnosed with lung cancer had either stool/effluent ELISA or Western blot positivity for Adnab-9 compared to only 1 of 11 controls (OR = 11.3, CI 1.3-97.9, p=0.014). The median time from stool submission to diagnosis of lung cancer was 4.4 (0.7-10.3) years. Lung Cancer Tumor types were adenocarcinoma in 23%; squamous in 33%; other in 20%; large cell cancer in 9%; small cell cancer in 8%; and unknown in 7%. At the last time of follow-up, 70% of patients subsequently diagnosed with lung cancer were deceased. Median survival time was 2.1 years from the time of clinical diagnosis. Conclusion: Adnab-9 sensitivity in this cohort was 52% with specificity of 90.9% for lung cancer and could lead to the diagnosis of lung cancer 4.4 years before clinical diagnosis was made. This supports the notion that accessible, early non-invasive testing combined with effective follow-up studies may lead to earlier diagnosis and treatment of lung cancer, the World's most frequent cancer. Citation Format: Martin Tobi, Joe Sayre, MaryAnn Rambus, Fadi Antaki, Ann Schwartz, Michael J. Lawson. Non-invasive diagnostic testing for lung cancer in a prospective cohort. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 882. doi:10.1158/1538-7445.AM2014-882