SESSION TITLE: Biomarkers in Lung Cancer
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Sunday, October 27, 2013 at 10:45 AM - 11:45 AM
PURPOSE: A blood based biomarker that is capable of accurately identifying lung cancer patients at high risk of having metastatic disease in the brain could lead to early identification of brain involvement in those affected while avoiding unnecessary brain imaging in those who are not. S100B is an astrocytic protein that enters the bloodstream when there is disruption of the blood-brain barrier (BBB). In time, antibodies develop to S100B that has left the brain. A longer duration of exposure may lead to higher antibody levels. The aim of our study is to understand the utility of the S100B protein and S100B antibody in the detection of brain metastasis in patients with lung cancer.
METHODS: One hundred and forty five untreated patients, newly diagnosed with lung carcinoma, were enrolled in this study. Patients had brain imaging as part of their routine evaluation. The presence of small vessel ischemic disease (SVID), known to lead to S100B elevation, was documented. Serum S100B protein levels were measured by ELISA and S100B auto-antibody by absorbance. The accuracy of the S100B level alone or in conjunction with auto-antibody levels was calculated.
RESULTS: Eighteen (12.4%) patients had brain metastasis at the time of lung cancer diagnosis. An S100B level of 0.05ng/ml had a sensitivity of 89% and specificity of 38% for brain metastasis. When an auto-antibody level of < 2.00 absorbance units was used in conjunction with the S100B level, the sensitivity remained at 89%, the specificity increased to 50%, and the negative predictive value was 96.2%.
CONCLUSIONS: A serum biomarker that includes S100B protein, and S100B auto-antibody levels, can accurately identify lung cancer patients with brain metastases.
CLINICAL IMPLICATIONS: The use of S100B and its antibody may be used to predict the presence of brain metastases in patients with lung cancer, reducing the rate of unnecessary brain imaging.
DISCLOSURE: Damir Janigro: Shareholder: Dr. Damir Janigro - who developed the S100B test and will get payments relating to this technology, is one of the principal investigators on this research study. The following authors have nothing to disclose: Humberto Choi, Vikram Puvenna, Chanda Brennan, Mary Beukemann, Peter Mazzone
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