Blood test shows promise to aid better detection of lung cancer

A blood test which can detect lung cancer at an early stage, and was pioneered by experts from the University of Nottingham, has produced positive top line results following a successful study in Scotland - Early Cancer Detection Test - Lung Cancer Scotland ("ECLS") Study.

The Early Cancer Detection Test for Lung Cancer (EarlyCDT-Lung®) is a blood test which detects cancer at its earliest stages of development through measuring antibodies produced by the body's immune system against proteins from the cancer cells.

This break-through in the diagnosis of lung cancer could save a significant number of lives as well as reduce the overall cost of care for this high risk population.

The ECLS trial of the revolutionary blood test, which has been co-developed by Oncimmune Ltd, a University of Nottingham company, spun-out in 2003, has successfully been carried out in Scotland with 12,209 participants at high risk of lung cancer, each of whom were followed up for a minimum of two years. It is believed to be worldwide, the largest randomised controlled study of early cancer detection using biomarkers of (lung) cancer measured in the blood.

The EarlyCDT®-Lung Test, followed by low-dose CT imaging for those who test positive, identified 32% of lung cancers which occurred, with a high specificity of 90%.This facilitated detecting lung cancer earlier thereby significantly reducing late-stage presentation of the disease, allowing for earlier treatment and this is likely to reduce mortality rates.

Professor Frank Sullivan, co-chief investigator of the study, said, "This study moves us closer to making an earlier diagnosis of lung cancer, which could have a significant impact in saving lives."

The blood test is based on pioneering research into the body's immune response to cancer carried out over the last 23 years by Professor John Robertson who is Professor of Surgery and Director of the Centre of Excellence for Autoimmunity in Cancer (CEAC) at the University of Nottingham and former Chief Scientific Officer of Oncimmune Ltd.

Professor John Robertson said: "After many years of work inventing and then developing this test, I am very proud at what has been achieved. Taking an idea from a concept in 1995, through the initial research, intellectual property, technical development programme into a clinical test that patients can use, has been an incredible journey and privilege.

"This journey has been shared with other academic colleagues at the University – Professor Herb Sewell (Immunology) for the last 16 years and Professors Denise Kendrick & Kavita Vedhara (Primary Care) who have lead the evaluation of psychological and behavioural outcomes in the clinical ECLS study.

"We know that early detection saves lives. EarlyCDT-Lung® is a significant step forward in early detection although we have further work to complete to optimise a blood test for early cancer detection, particularly for the three most common cancers (lung, colon and breast cancers), which cause so many deaths.

"We are now working in CEAC to bring the next tests for the early detection of breast and gastrointestinal (ie colorectal, pancreatic) cancers to a similar clinical utility as the lung cancer test."

Professor Sewell who was previously Pro Vice Chancellor for Research at the University of Nottingham commented "The University Management Board realised the potential of this translational research project from very early on. It has actively supported it in multiple ways throughout the last 20 years, starting under Professor Sir Colin Campbell and continued under Professor Sir David Greenaway and the current VC Professor Shearer West.

"Indeed the University continues to support this academic research programme – e.g. by reinvesting some of the money received from its interest in Oncimmune into a CEAC Clinical Fellowship which was recently appointed for 5 years. It has been an exciting journey to be initially involved as the University's representative on the Oncimmune Scientific Advisory Board and the subsequently collaborating as a co-investigator on both the ongoing academic laboratory research and the ECLS trial"

The ECLS study was sponsored by the University of Dundee and NHS Tayside and co-funded by the Chief Scientist Office, Scottish Government and Oncimmune and was headed by Principal Investigators, Professor Frank Sullivan, Professor of Primary Care Medicine at the University of St. Andrews and Dr Stuart Schembri, until recently consultant Physician in Respiratory and General Internal Medicine at NHS Tayside.

Lung cancer is the world's leading cause of cancer-related mortality and a major source of morbidity and mortality in the UK. Eighty five per cent of patients with lung cancer remain undiagnosed until the disease is symptomatic and has reached an advanced stage.

Scotland has had one of the highest rates of lung cancer in the world. Survival across the UK is poor with less than nine per cent of patients still alive five years after diagnosis. This is due primarily to late stage of presentation.

Early detection of lung cancer and diagnosis improves prognosis — the current five-year survival rate is approximately 60 per cent for stage one lung cancer but only one per cent for those with stage four disease.

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