Less drastic for patients: detecting lung cancer with blood tests

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If lung cancer is suspected, a ‘bite’ of tissue is removed and examined under the microscope. This may change in the future. Sylvia Roovers-Genet examined proteins in the blood of people with, without and possibly lung cancer during her PhD research. She used this to develop a method to detect lung cancer through blood tests. This method can be developed in the future, with the aim of making it suitable for predicting lung cancer. Sylvia Roovers-Genet defended her dissertation at the Biomedical Engineering faculty on February 1.

Already at the start of her PhD at the Faculty of Biomedical Engineering, Sylvia Roovers-Genet knew that she would consciously work towards a clinical application. Not surprising when you consider that she conducted her research in close collaboration with colleagues from the Catharina Hospital and the Máxima Medical Center in Eindhoven/Veldhoven. The aim was to look for characteristic proteins (markers) in the blood of lung cancer patients.

Sylvia Roovers-Genet. © Vincent van den Hoogen

Roovers: “It is important to know that lung cancer is often talked about as if it were one condition, while there are many different forms. Each with its own treatment and approach. It is therefore very important for a pulmonologist to know exactly which variant he or she is dealing with.”

Current approach

“There is currently a gold standard for determining whether someone has lung cancer. If there is a suspicion, the first step is a scan, such as CT or PET CT. This provides insight into where the complaints may come from and where the possible cancer cells or tumor are located.”

The second step is a biopsy. “To be sure that it is cancer and not another condition, only a biopsy of lung tissue currently provides certainty. But that evidence of tumor cells is not always available. Sometimes people are too old or too sick and the biopsy itself is too risky for their health. And sometimes people refuse to undergo the procedure.”

Looking for a new method

“That is why we started looking for a method that is much less invasive for patients. Taking blood samples is much less painful and risky. Especially for the risk group for lung cancer, where smoking and old age are the most important risk factors,” says Roovers.

Technician holding blood tube test in the research laboratory. © iStock/Merovingian

For the study, it was important to examine blood from at least three groups of people: with, without and with possible lung cancer. “No fewer than six Dutch hospitals participated in the study by asking patients if they wanted to participate when they came to the lung doctor with a suspicion of lung cancer. Relevant patient data was then recorded and their blood was examined to determine the proteins.”

Ultimately, more than a thousand people participated in the study. Due to the size of that group, the results from Roovers’ PhD research are very reliable. It was interesting to see, for example, that in thirteen percent of patients with the current gold standard it could not be conclusively determined whether these patients had lung cancer. Blood tests might provide a solution for these patients in the future.

Computed tomography (CT) of the chest. Black and white picture. © iStock/Sudok1

Protein analysis to detect lung cancer

The patient research produced an enormous database, with which Roovers and fellow researchers could get to work. “We have developed new detection methods for quantifying two promising lung cancer protein tumor markers based on liquid chromatography-tandem mass spectrometry (LC-MS/MS). This is a method that looks at the weight of proteins in the blood and thus recognizes tumor markers.”

“We were able to detect these markers even at very low concentrations in the blood of patients with lung cancer. The new methods can help further research to find out whether LC-MS/MS-based detection can also be of added value in clinical practice in hospitals compared to current methods,” says Roovers.

Go to the doctor’s office

To facilitate the step to the hospital, or clinical practice, Roovers and colleagues developed not only the diagnostic method, but also a decision algorithm for doctors.

“It is not one marker that you should pay attention to as a doctor, it is a combination of factors. That is why we help doctors to correctly interpret the results of blood tests according to our method. With our method, we can now say for two-thirds of patients with at least 95 percent certainty that they have lung cancer, based on blood tests.”

We have now scientifically proven that lung cancer can be detected in the blood.

Sylvia Roovers-Genet

When asked about the practical application, Roovers keeps his distance. “We have now scientifically proven that lung cancer can be detected in the blood. The next step is always a validation study in practice. This is being set up and implemented through a collaboration between TU/e, the Catharina Hospital and Máxima Medical Center.”

Need a shot at the doctor?

And after that? Just go to the doctor and have a blood test to find out if you have lung cancer? “Who knows,” says Roovers, laughing. “But that is not the case yet. Make no mistake, lung cancer is unfortunately still very deadly. After five years, only nineteen percent of people with lung cancer are still alive. So it would be fantastic to find these form(s) of cancer earlier, so that they can be better treated.”

Title of Sylvia Roovers-Genet’s dissertation: Lung cancer protein tumor markers: Development, validation and clinical use of quantitative serum tumor marker assays.

The article is in Dutch

Tags: drastic patients detecting lung cancer blood tests

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