Abstract P013: Impact of blood-based biomarkers for predicting lung cancer mortality in the PLCO cohort

Abstract

Abstract Purpose: To investigate the utility of integrating a panel of circulating protein biomarkers in combination with a risk model based on subject characteristics for identifying individuals at high risk of harboring a lethal lung cancer. Methods: Data for a 4-marker protein panel (4MP) (consisting of the precursor form of surfactant protein B, cancer antigen 125, carcinoembryonic antigen, and cytokeratin-19 fragment) previously assayed in pre-diagnostic sera from 552 lung cancer cases and 2,193 non-cases from the Prostate Lung Colorectal and Ovarian (PLCO) cohort as well as a scores from a logistic regression model that combined the 4MP with the PLCOm2012 risk model were used for this study. Of the 552 lung cancer cases, 387 (70%) died from lung cancer. Cumulative incidence of lung cancer death as well as sub-distributional and cause-specific hazard ratios were calculated based on 4MP+PLCOm2012 risk scores at a pre-defined 1.0%/6-year risk threshold, which corresponds to current US Preventive Services Task Force screening criteria. For hazard modeling, stage at the time of clinical diagnosis and treatment modality were considered as co-variables. Results: When considering cases diagnosed within 1 year of blood draw and all non-cases, the performance estimate of the 4MP+PLCOm2012 model for risk prediction of lung cancer death was 0.88 (95% CI: 0.86-0.90). Among cases only, at the 1.0%/6-year risk threshold the cumulative incidence of lung cancer death was statistically significantly higher in ‘test positive’ cases compared to ‘test negative’ cases (Chi-square test: 5.42, P: 0.02). The adjusted sub distributional hazard ratio for ‘test positive’ cases was 1.67 (95% CI: 1.02-2.74). The adjusted lung-cancer death-specific hazard ratio for ‘test positive’ cases was 2.02 (95% CI: 1.28-3.17). Conclusions and Relevance: The blood-based biomarker panel in combination with PLCOm2012 identifies individuals at high risk of a lethal lung cancer. Citation Format: Ehsan Irajizad, Johannes F. Fahrmann, Jody V. Vykoukal, Jennifer B. Dennison, James P. Long, Kim-Anh Do, Edwin J. Ostrin, Sam Hanash. Impact of blood-based biomarkers for predicting lung cancer mortality in the PLCO cohort. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P013.