Date: 21 January 2019
NIHR researchers have undertaken the world’s first genetic sequencing of precancerous lung lesions, a development that could pave the way for very early detection and new treatments.
Precancerous lesions can be found in the airway before lung cancer develops. However, only half of these will actually become lung cancer, while others will disappear or remain benign without becoming harmful. The lesions look the same under the microscope, making it difficult to know which ones to treat.
In this study, supported by the NIHR University College London Hospitals Biomedical Research Centre, researchers have for the first time discovered the differences between the lesions that are dangerous and those that are harmless, and they can accurately predict which ones will become cancerous.
“Our study helps to understand the earliest stages of lung cancer development, by figuring out what’s going on inside these cells even before they become cancerous,” said the study’s lead author, Professor Sam Janes from the UCL Division of Medicine and University College London Hospitals.
“Using this information, we may be able to develop screening tests, and new treatments that could stop cancer in its tracks.”
The researchers conducted genetic tests on biopsies of preinvasive lung cancer lesions from 85 patients who were seen at UCLH.
The patients were then followed up for over five years after their biopsy to see who developed lung squamous cell carcinoma, one of the two most common subtypes of lung cancer.
The research team identified differences in genomic features between people who developed lung cancer and those who did not, finding enough differences that they could predict with near-perfect accuracy which lesions would develop into cancer by checking the lesion’s molecular profile.
By identifying which precancerous lesions are harmful, the researchers say clinicians could decide whether or not to offer a patient surgery at a much earlier stage of the disease than is currently possible, while saving others with benign lesions from unnecessary surgeries.
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