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Test of Nasal Skin Cells Found to Detect Lung Cancer

Lungs illustration

(National Cancer Institute)

27 February 2017. A diagnostic test analyzing the genes in skin cells from nasal passages can detect lung cancer, and the absence of cancer, as accurately as more invasive samples from the airways. Results of this study testing a technology by diagnostics company Veracyte Inc. appear in today’s issue of the Journal of the National Cancer Institute (paid subscription required).

The study assesses the technology behind Veracyte’s Percepta bronchial genomic classifier, a device that normally evaluates cell samples taken from the airways of individuals suspected of having lung cancer, but in this case also with cells taken from nasal passages. Airway cell samples are collected for the test during a bronchoscopy, where a cancer specialist can view the condition of a person’s airways and lungs with a miniature camera on a flexible tube inserted through the windpipe, from the nose or mouth, as well as take tiny biopsy samples. Although bronchoscopies are considered minimally invasive, patients may need to be sedated or given a local anesthetic, or even a general anesthetic.

Veracyte’s Percepta test analyzes samples taken with a bronchoscopy for biomarkers, or molecular indicators of tumors, from 23 genes expressed in the airways to supplement the physician’s visual observations. Clinical evidence offered by the company says Percepta tests improve the accuracy of bronchoscopies, to not only diagnose lung cancer earlier, when treatment can be more effective, but also more accurately identify benign tumors and reduce by half unnecessary lung surgeries.

The researchers, led by Boston University medical and bioinformatics professor Avrum Spira, guessed that nasal passages of smokers, a group more likely to contract lung cancer, would express similar damage, and thus similar biomarkers, as their airways. Thus, if skin cell samples from nasal passages could be used to detect lung cancer as accurately as cells from airways, lung cancer could be detected easier and sooner, as well as reduce uncertainties and distress of people without cancer.

Spira and colleagues enrolled 505 individuals already taking part in two lung cancer clinical trials, who were undergoing bronchoscopies as part of the trials. These same individuals offered nasal swabs from which the researchers tested for biomarkers and compared the results to the bronchoscopies. Participants were also tracked for 1 year after giving their initial nasal swab samples.

The study team found nasal samples offer biomarkers expressed from 30 genes indicating either the presence or absence of cancer, which when combined with clinical factors such as age and smoking history, can predict future lung cancer cases. The researchers likewise found similar biomarker expressions in the nasal passages and airways of participants in the studies, both those developing and not developing tumors. In addition, after 1 year, the genes in the nasal swab samples of participants could accurately predict individuals more likely to develop cancerous lung tumors and those with benign conditions.

The authors conclude that the so-called field of injury for lung cancer extends to nasal passages, with the results demonstrating the potential of nasal swabs as a less invasive method for lung cancer screening. “This discovery,” says Spira in a Veracyte statement, “could offer a method to further reduce the uncertainty, risk, and cost associated with the early detection of lung cancer.”

Spira is an entrepreneur as well as a physician-scientist, and holds a professorship in health care entrepreneurship at Boston University, as well as his other faculty posts. He is one of the founders of the company Allegro Diagnostics in Maynard, Massachusetts which, as reported by Science & Enterprise, first developed a commercial test of biomarkers in the airways. In September 2014, Veracyte, in South San Francisco, California acquired Allegro Diagnostics and Spira’s technology.

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