Boston University School of Medicine (BUSM) has received a $13.6 million grant and been named the lead institution in a study aimed at developing novel technologies for the early detection of lung cancer. The 5-year multisite, multiphase study, funded by the US Department of Defense’s Lung Cancer Research Program, will focus on active military personnel and veterans. The Detecting Early Lung Cancer Among Military Personnel (DECAMP) Consortium represents the largest consortium of researchers dedicated to identifying noninvasive ways to detect lung cancer early.

BUSM will collaborate with military hospitals and Veteran’s Affairs medical centers across the country that collectively have the ability to investigate a larger number of patients and gain access to a diverse variety of researchers and tools.

In the military population, smoking rates are about 50% higher than the civilian population, and veterans in particular are 25% to 75% more likely to develop lung cancer than nonveterans. An increased in smoking among members of the armed forces stationed in Afghanistan and Iraq has also been noted, as well as a 50% higher rate of smoking in deployed versus non-deployed personnel. Additionally, the exposure to other substances in the air when in combat, including radon, asbestos, and fuel exhaust, is elevated among military personnel.

"Current lung cancer detection methods involve invasive procedures that are often done only after symptoms occur, and by that time, the cancer has spread outside of the lungs and can be difficult to treat," said Spira. "Using advanced imaging techniques and testing molecular biomarkers that indicate risk of a future lung cancer diagnosis will help in the development of non-invasive, accurate methods to detect lung cancer before it becomes untreatable."

The DECAMP consortium will address two critical clinical questions that are the direct consequence of the recently completed National Lung Screening Trial (NLST). Results from that study indicate that lung cancer screening with low-dose computed tomography (CT) scans of the chest can reduce lung cancer mortality among individuals at a high risk of developing the disease. One of the limitations of the CT scans in that study was the high false positive rate; nearly 24% of smokers in the NLST trial had an abnormality on the CT scans that was considered positive for lung cancer. Only 4% of these, however, turned out to be lung cancer, while 96% were false-positive results.

Through the DECAMP consortium, the researchers will use molecular biomarkers to more accurately distinguish between benign and cancerous lung nodules observed on CT scans. This first phase of the study will look at a group of 500 current and former smokers whose CT scans showed small pulmonary nodules that represent a diagnostic dilemma in terms of which patients will need an invasive work up via lung biopsy versus those patients that can be managed conservatively with follow up imaging studies.

The goal of the second phase of the study is to identify biomarkers that can predict which smokers are at risk for future development of lung cancer among those without any symptoms or abnormalities on CT scans of the chest. There will be approximately 1,000 high-risk subjects recruited for this phase. They will be followed for 4 to 5 years with the objective of discovering the biomarkers that can identify those at risk for developing lung cancer who would most benefit from both more intense screening efforts via annual CT scans, as well as treatment as part of ongoing clinical trials with new agents that may prevent lung cancer.

Source: Boston University Medical Center