25th November 2019

‘World-First’ study could pave way for new early lung cancer detection and treatments 

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A research project backed by Roy Castle Lung Cancer Foundation is providing crucial insights into why some changes in body tissue eventually develop into cancer while others do not.

A team of scientists at UCL (University College London) led by Prof Sam Janes are looking into this issue. Their work might provide the basis for new ways to detect squamous lung cancer at a very early stage and even new treatments for it.

They have just published details of the latest stage of their work in a paper titled, “Immune surveillance in clinical regress of pre-invasive squamous cell lung cancer”.

Before lung cancer develops, damaged tissues – called precancerous lesions – are found in the airway. Only half of these will progress to become lung cancer, while others will remain benign or simply disappear.

Under the microscope, all these lesions look the same, making it difficult to establish which ones to treat and which ones to leave alone. However, this innovative study has discovered the differences between lesions, allowing them to accurately predict which ones will become cancerous.

The researchers believe this information could be used to help clinicians to decide whether to offer a patient surgery at a much earlier stage of the disease than is currently possible, while saving others whose lesions are benign, from enduring unnecessary surgery.

These findings could also help to develop a simple blood test to pick up the same molecular signals linked to early cancer development as well as leading to new treatments.

Professor Janes explains more: “Our study helps understand the earliest stage of lung cancer development by figuring out what’s going on inside these cells even before they become cancerous.

“Using this information, we may be able to develop screening tests, such as blood tests, and new treatments that could stop lung cancer in its tracks.”

The team studied biopsies of preinvasive lung cancer lesions from patients from University College London Hospital (UCLH). They conducted tests including gene expression profiling, methylation profiling and whole-genome DNA sequencing.

Patients were followed up for over five years after their biopsy to see which of them developed lung squamous cell carcinoma, one of the two most common subtypes of lung cancer.

The team found sufficient differences that, when checking the lesions’ molecular profile, they could predict with near-perfect accuracy which would develop into cancer.

They are is now continuing the research to further understand how these genes drive the progression of lung cancer and to see which ones could be targeted by new drug treatment.

Co-author of the study, Dr Adam Pennycuick, adds: “If we use this understanding of cancer development to create new diagnostic tests, it may one day be invaluable in picking up lung cancer early and enable people to access treatment far sooner.”

Paula Chadwick, chief executive of Roy Castle Lung Cancer Foundation, takes great pride in the team’s achievements.

She said, “Our charity has always been dedicated to supporting innovative research projects. We’ve always focused our funding towards projects aimed at improving early detection of the disease, and, so far, this project looks very promising indeed.

“It all adds to the sum total of our knowledge and understanding of lung cancer and how it develops. Knowledge is the key to making a real difference to the lives of all people affected by lung cancer.”