Study supports ASU researchers' pioneering work in cancer screening

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 Patients screened with CT scan 20 percent less likely to die from lung cancer

The National Cancer Institute (NCI) has released the initial results from a large-scale clinical study of lung cancer screening methods that now provide confirmation of pioneering work led by ASU’s Biodesign Institute researchers. The study confirms that CT screening sharply reduces deaths from lung cancer by detecting cancers at relatively early stages.

The NCI’s National Lung Screening Trial (NLST), a randomized national trial involving more than 53,000 current and former heavy smokers ages 55 to 74, compared the effects of two screening procedures for lung cancer – low-dose helical computed tomography (CT) and standard chest X-ray – on lung cancer mortality and found 20 percent fewer lung cancer deaths among trial participants screened with low-dose helical CT.

These results provide further evidence of the benefits for the early detection of lung cancer using CT scans – research of an ASU effort led by Biodesign Institute researchers Claudia Henschke and David Yankelevitz, who published the first major study on the benefits of CT scans for lung cancer survival rates in the New England Journal of Medicine in 2006.

“I am thrilled and looking forward to working collaboratively with the NCI and other government agencies to implement this life-saving screening,” Henschke said. “The mortality reduction shown now is only the beginning and it will continue to increase over the next years. If screening had continued for 10 years rather than three in the NLST, the mortality reduction would eventually be what is estimated by the curability rate we published in the NEJM.”

Today, 85 percent of patients diagnosed with lung cancer in the United States will die within five years. Hope has been found in the early detection of lung cancer with annual CT screening of high-risk individuals. Henschke’s research study has shown that annual screening with CT scans can find lung cancers in their earliest stage, when up to 92 percent can be cured.

“CT scans are unequivocally the most reliable tool currently available for the early detection of lung cancer,” Henschke said. “The diagnosed cancers discovered by CT scanning are true malignancies. The evidence of this is unassailable and the vast majority, left untreated, would cause the death of the individual.”

Henschke and Yankelevitz are researchers at the Biodesign Institute at ASU and physicians at Mount Sinai Medical Center in New York City. They serve as the scientific and administrative leaders of the International Early Lung Cancer Action Program, or I-ELCAP, the first-ever global, grassroots study of its kind. Since 1993, this massive and unprecedented study has established a new paradigm for how research should be conducted and could change the research landscape while saving tens of thousands of lives, not to mention millions of dollars.

“The Biodesign Institute has a major initiative under way in lung cancer research, in partnership with Henschke and Yankelevitz, is the foundation demonstration project for a large-scale, Biodesign-led biosignature research program,” said Alan Nelson, executive director of the Biodesign Institute at ASU. “They are national and international leaders in lung cancer, and the pioneering work that they’ve done in using CT in the early detection of tumors and the mortality benefits are creating new clinical trial paradigms that will help overcome the deadly threat of lung cancer.”

The International Early Lung Cancer Action Program, or I-ELCAP, is a lung cancer research organization with 60 cancer centers in 26 states and eight other countries whose mission is to reduce deaths from lung cancer by early detection and diagnosis through screening by computed tomography (CT). Since 1993, they have been gathering scientific data using a common, continually updated screening protocol. More than 53,000 people at high risk for lung cancer have had CT screening thus far. The data is pooled and contributes to their ongoing research regarding best practices for CT screening.

“We, as part of I-ELCAP, have long been practicing methodologies for research that ensure the most accurate, scientific results,” Henschke said. “We know our methodology is both ethical and reliable. Our study is focused on cure rates–how often we are finding cancers that would have led to death, and among them, how often they are cured. Our approach focuses on lung cancer cure rates; the NCI study looked at mortality. The relationship between these endpoints is complex, but they are interrelated and screening has to be continued long enough to show the relationship. But, it is clear that you cannot get a mortality reduction unless you cure people.”

The group is using multiple approaches and lines of investigation to enrich the understanding of lung cancer screening and its effectiveness. The I-ELCAP effort is now part of a lung cancer demonstration project for the new ASU Biosignature Initiative directed by Deirdre Meldrum, also director of the Center for Biosignatures Discovery Automation (CBDA) in the Biodesign Institute.  New efforts will focus on biosignature discovery from lung cells using VisionGate’s first academic research demonstration of a state-of-the-art 3-D cell imaging technology to identify pre-cancer biosignatures.

“Working in close collaboration with Henschke and Yankelevitz, we are pioneering a non-invasive sputum test that would triage at-risk patients to low dose CT scanning as a comprehensive screening protocol that may eventually become the standard of care," Meldrum said.

With this burgeoning research portfolio, ASU’s Biodesign Institute and the Biosignature Initiative will continue to be at the forefront of efforts for the early detection of lung cancer to save lives.

See below to read national media articles on the study:

ABC World News: CT scans may catch lung cancer earlier than x-rays: NCI

msnbc.com: 'Spiral' CT scans can cut lung cancer deaths

New York Times: Cancer deaths reduced by CT scans, study finds

Wall Street Journal: Deaths from lung cancer curtailed by screening test

USA Today: CT scans can reduce lung cancer deaths by 20 percent

The NLST was sponsored by NCI, a part of the National Institutes of Health, and conducted by the American College of Radiology Imaging Network (ACRIN) and the Lung Screening Study group.  A paper describing the results was published yesterday by the journal Radiology and is openly available here.

Media contact:
Joe Caspermeyer, joseph.caspermeyer@asu.edu
Associate Director, Communications
The Biodesign Institute at ASU
(480)-727-0369