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2017 ; 107
(ä): 50-58
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Integration of multiple "OMIC" biomarkers: A precision medicine strategy for lung
cancer
#MMPMID27344275
Robles AI
; Harris CC
Lung Cancer
2017[May]; 107
(ä): 50-58
PMID27344275
show ga
More than half of all new lung cancer diagnoses are made in patients with locally
advanced or metastatic disease, at which point therapeutic options are scarce. It
is anticipated, however, that the widespread use of Low-Dose Computed Tomography
(LDCT) screening, will lead to a greater proportion of lung cancers being
diagnosed at an early, operable, stage. Still, the overall rate of recurrence for
surgically treated Stage I lung cancer patients is up to 30% within 5 years of
diagnosis. Thus, the identification and clinical application of biomarkers of
early stage lung cancer are a pressing medical need. The integrative analysis of
"omic," clinical and epidemiological data for single patients is a core principle
of precision medicine. Through rigorous bioinformatics and statistical analyses
we have identified biomarkers of early-stage lung cancer based on DNA
methylation, expression of mRNA and miRNA, inflammatory cytokines, and urinary
metabolites. Beyond a more comprehensive understanding of the molecular taxonomy
of lung cancer, these biomarkers can have very practical implications in the
context of unmet clinical needs of early stage lung cancer patients: First,
current guidelines for LDCT screening broadly include individuals based on age
and history of heavy smoking. Tumor-derived circulating biomarkers in the blood
and urine associated with lung cancer risk could narrow and prioritize
individuals for LDCT screening. Second, a high number of nodules are identified
by LDCT, of which fewer than 5% are finally diagnosed as lung cancer. Biomarkers
may help discriminate malignant nodules from benign or indolent lesions. Third,
the expected rise in the numbers of lung cancer patients diagnosed at an early
stage will necessitate new treatment options. Circulating, urinary and
tissue-based biomarkers that molecularly categorize Stage I patients after tumor
resection can help identify high-risk patients who may benefit from adjuvant
chemotherapy or innovative immunotherapy regimens.