Blood test clue for lung cancer treatment

Cancer Research UK

CANCER RESEARCH UK-funded scientists have identified a new molecular marker in blood which could indicate how patients with a type of lung cancer will respond to treatment, according to research published in Clinical Cancer Research*.

Researchers at the Physiological Laboratory, University of Liverpool and cancer specialists at Clatterbridge Centre for Oncology found that a molecule called SCG3 mRNA** in the bloodstream has a high association with a type of lung cancer called neuroendocrine small cell lung cancer (SCLC).

The marker could be developed for use in blood tests to see how well patients might respond to treatment for this type of lung cancer. The discovery may in future help doctors make more informed decisions about therapy or recommend that patients take part in trials to try new treatments that might be more effective for them.

There are presently no clear biological markers in blood suitable for identifying how well SCLC patients will respond to treatment, so all patients presenting with SCLC - one of the two main types of lung cancer*** - are usually treated with the same standard form of chemotherapy.

Patients with neuroendocrine SCLC are not usually able to have surgery because of multiple tumours which make operations difficult. Many patients initially respond to chemotherapy and radiotherapy, but their tumours are likely to reoccur, which is why it is so important to ensure that patients receive the optimum treatment for this disease.

Dr Judy Coulson, Cancer Research UK-funded lead author based at the University of Liverpool's, School of Biomedical Sciences, said: "There are currently no blood-based markers routinely used to monitor patients with this type of lung cancer.

"We found that SCG3 mRNA is an incredibly sensitive marker of these tumours and it could be used to detect circulating tumour cells in patients with this disease."

Lung cancer is the greatest UK cancer killer - some 33,500 individuals die from the disease in the UK each year accounting for 22 per cent of UK cancer deaths. Progress in improving survival for lung cancer has been very slow especially in comparison to some of the other common cancers such as breast or bowel cancer where survival rates have increased steadily over the past three decades.

Cancer Research UK has launched a five year strategy to reduce cancer death. This will see £300 million spent each year in core areas of science and will include increased investment in those cancers where survival remains poor, including lung, pancreas and oesophageal cancer.

Lesley Walker, Cancer Research UK’s director of cancer information, said: "This discovery is an important step to understanding how to treat lung cancer patients more efficiently. Lung cancer can be very difficult to treat in the later stages, either because it has spread of because there are too many tumours. Chemotherapy is therefore a vital part of lung cancer treatment.

"Anything that improves our knowledge of how to best treat lung cancer is crucial work."

ENDS

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Notes to Editor

*Judy Coulson et al. SCG3 transcript in peripheral blood is a prognostic biomarker for REST deficient small cell lung cancer. Clinical Cancer Research, 1January 2009.

**A transcription factor called REST (RE-1 silencing transcription factor) is lost in SCLC. Gene screening showed that when REST is depleted in tumour cells this results in abnormal regulation of genes. The most startling effect of REST depletion in lung tumour cells was a large increase in the presence of SCG3 mRNA, suggesting it might be a good marker for SCLC.

The mRNA is a messenger molecule that translates genetic information held on DNA into a protein that carries out normal functions in neuroendocrine cells of the body. This marker is present and detectable in the blood of these cancer patients when neuroendocrine cancer cells are shed into the bloodstream.

*** There are two main types of lung cancer, non small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). They occur in different areas of the lung. A third (32 per cent) of all lung cancers - across both types - are neuroendocrine which means the tumor cells secrete chemical messengers that may help to progress tumor growth.

Patients with neuroendocrine forms of lung cancer can be classified into limited disease which means they have smaller tumours and do not carry metastasis or they may present extensive disease which means they have developed large lung tumours.

Anyone affected by cancer can contact Cancer Research UK’s cancer information nurses on 0808 800 4040 (freephone) or visit the charity's patient information website CancerHelp UK.

Lung Cancer

Lung cancer kills more people worldwide than any other malignancy. Currently 33,500 individuals die each year in the UK from lung cancer. The number of deaths has fallen in the past years and this is likely to be due to a decline in tobacco smoking, and possibly greater public awareness.

There is now a large ex-smoking population in the UK and Europe, who remain at high risk of developing lung cancer, which is dependent on their smoking duration prior to tobacco cessation. This group of individuals will continue to do so over the next two to three decades.

Smoking cessation

Giving up smoking decreases cancer risk. Different people give up in different ways, whether this is working towards a quit date or giving up on the spur of the moment, so individuals should decide what will work best for them.

Research shows people are much more likely to succeed in quitting with professional support and advice on medication. The NHS has services to help people give up., including stop smoking groups, one-to-one counseling and the Together programme to help people give up at home. For more information call the NHS Smoking Helpline on 0800 169 0 169 (open 7am-11pm every day) and visit www.givingupsmoking.co.uk.

University of Liverpool

The University of Liverpool is a member of the Russell Group of leading research-intensive institutions in the UK. It attracts collaborative and contract research commissions from a wide range of national and international organisations valued at more than £108 million annually.

Clatterbridge Centre for Oncology

Clatterbridge Centre for Oncology NHS Foundation Trust serves a population of 2.3 million covering Merseyside, Cheshire, North Wales, the Isle of Man and South Lancashire.

The Wirral-based Trust employs 650 staff and provides specialist radiotherapy and chemotherapy services and delivers more than 112,000 treatments to patients every year. Visiting medical and nursing teams also deliver specialist cancer services at hospitals across the region.

Clatterbridge Centre for Oncology’s vision is to provide word class cancer care; we will achieve this by putting people first, achieving excellence, being passionate about what we do, always improving our care and being committed to our future.

For more information about the content of this press release, please contact the Communications Manager at Clatterbridge Centre for Oncology, Vicki Head, on 0151 482 7719 or email vicki.head@ccotrust.nhs.uk.

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