Biomarkers for early diagnosis, prognosis, prediction, and recurrence monitoring of non-small cell lung cancer

Abstract

Despite advances in the management of non-small cell lung cancer, it remains to be the leading cause of cancer-related deaths worldwide primarily because of diagnosis at a late stage with an overall 5-year survival rate of 17%. A reduction in mortality was achieved by low-dose computed tomography screening of high-risk patients. However, the benefit was later challenged by the high false positive rate, resulting in unnecessary follow-ups, thus entailing a burden on both the health care system and the individual. The diagnostic dilemma imposed by imaging modalities has created a need for the development of biomarkers capable of differentiating benign nodules from malignant ones. In the past decade, with the advancements in high-throughput profiling technologies, a huge amount of work has been done to derive biomarkers to supplement clinical diagnosis. However, only a few of them have efficient sensitivity and specificity to be utilized in clinical settings. Therefore, there is an urgent need for the development of sensitive and specific means to detect and diagnose lung cancers at an early stage, when curative interventions are still possible. Due to the invasiveness of tissue biopsies and inability to capture tumor heterogeneity, nowadays enormous efforts have been invested in the development of technologies and biomarkers that enable sensitive and cost-effective testing using substrates that can be obtained in a noninvasive manner. This review, primarily focusing on liquid biopsy, summarizes all documented potential biomarkers for diagnosis, monitoring recurrence treatment response.

Circulating Tumor Cells Correlate with Clinicopathological Features and Outcomes in Differentiated Thyroid Cancer

“…They have been widely used for early DM detection, monitoring prognoses and treatment efficacy, and risk stratification for some solid tumors [10,11] . The CellSearch system is the most widely used assay for CTCs, and depends on expression of CTC-surface epithelial cell adhesion molecule (EpCAM) [12].…”

Increased expression of SLC35F2 in non-small cell lung cancer predicts poor prognosis

“…Regional or distant metastasis is a risk factor for relapse and poor prognosis of NSCLC (3). However, there are currently no effective biomarkers to predict poor prognosis in NSCLC (4). Therefore, there is an urgent need to identify new markers to predict poor prognosis in NSCLC (5).…”

CD117 expression is correlated with poor survival of patients and progression of lung carcinoma:a meta-analysis with a panel of 2645 patients

“…Distinguishingthesubtypesoflungcarcinomais crucialfordeterminingthebestchoiceoftherapeutic strategies [14].Althoughalotofresearchhasbeen doneforthediagnosisandtreatmentoflungcancer overthelastdecade,thedeathrateofpatientswith lung cancer remains high. Patients with advanced stage disease are prone to higher morbidity when comparedwiththoseatearlystages.Unfortunately, mostpatientshavealreadyprogressedtoanadvanced stage when their diagnosis is made, having missed theoptimaltreatmenttiming [15,16,17,18,19]. Thissituationemphasisestheimportanceandvalue ofsearchingforbiomarkersthatareconducivetopredicttheprognosisoflungcarcinoma.…”