Doctors closing in on possible lung cancer test

CHICAGO, Illinois (Reuters) -- Doctors searching for a way to detect lung cancer with a simple blood test reported Wednesday that they have found a potential marker in bone marrow that may help them identify when the disease is present.

Thomas D'Amico and his colleagues at Duke University Medical Center in Durham, North Carolina said the chemical marker, called cytokeratin 19, may help them screen out lung cancer victims at an early stage, helping them determine what kind of treatment to use.

In a report issued at the annual clinical congress of the American College of Surgeons, they said, however, that they do not yet know if the marker is the one that eventually will be the most useful.

"The real test will be when we study patients to find out whether cytokeratin 19 truly predicts survival, so we can treat patients differently," D'Amico said.

Non-small cell lung cancer, the most common form of the disease, is difficult to track, the college said in background information it released with the report.

Patients with early stages of the disease often have surgery while those with more advanced cases receive both surgery and chemotherapy or radiation therapy. Those with the most advanced cases are often given only chemotherapy and perhaps palliative care, it said.

D'Amico's report said the bone marrow of 34 patients with suspected or proven non-small cell lung cancer were examined. The marker, found on the surface of tumors, occurred in five of 21 patients with confirmed early stage lung cancer and three of eight patients with advanced disease.

"Currently, we do not know of a distinct marker that everyone with lung cancer expresses in the same way," D'Amico said. "There is no marker for lung cancer that is similar to prostate specific antigen, which is almost universal as a marker for prostate cancer.

"We are trying to find a marker that occurs only in people who have lung cancer; it must be a marker that can be found in (blood serum), lymph nodes, or bone marrow, and that is both sensitive and specific for lung cancer," he said.

D'Amico said the Duke researchers are trying to develop a general blood test to screen patients for lung cancer. While the bone marrow marker may provide needed information, a blood test would be easier to perform than one using bone marrow for a wide variety of patients, he said.

"In the ideal situation, a high-risk person, such as an elderly patient or someone with a long history of smoking or a family history of lung cancer, could come in and get a blood test that would determine whether they have early signs of lung cancer," he said.

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American College of Surgeons: Commission on Cancer
Alliance for Lung Cancer

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