Research Perspectives

Uniting Works with Canary Foundation to Advance Early Detection Studies of Lung Cancer

Uniting Against Lung Cancer spoke with Dr. Samir Hanash, Program Head of Molecular Diagnostics at the Fred Hutchinson Cancer Research Center and Project Leader of the Canary Lung Team, about ways to detect lung cancer early using biomarkers.

UALC: What are biomarkers and how can they help us detect lung cancer?

Dr. Hanash: Put very simply, biomarkers are either molecules or cells that you can measure. In the case of lung cancer, lung tissue may be producing particular molecules or cells or, alternatively, other parts of the body sensing the presence of cancer may be releasing particular molecules or cells. We can develop tests to measure these cells or molecules by taking them out of the body (for example, a blood test if they are released into the circulation) or looking inside the body (an imaging test).

UALC: What is an example of a biomarker success story in another cancer?

Dr. Hanash: The most famous example would be PAP smears to screen for cervical cancer. If you find abnormal cells, you can act on that information to prevent cancer.

UALC: What are the goals for diagnostic tests for lung cancer?

Dr. Hanash: We want to be able to determine whether someone is at risk of developing lung cancer, detect the cancer at an early stage, and make a definitive diagnosis of the disease. After a definitive diagnosis, we also want a test to determine if the treatment is working and, later, if there is recurrence. Each one of those applications will likely require different sets of tests and biomarkers.

UALC: What are the challenges to identifying biomarkers specific to lung cancer to develop tests that will be informative?

Dr. Hanash: The reality is that lung cancer is extremely heterogeneous, meaning there are many different types. We have pretty good indications that lung cancer in smokers is a different disease than lung cancer among individuals who have never smoked. Then there are different histological types--squamous cell carcinoma, adenocarcinoma, small cell carcinoma--based on different features we can see under the microscope. Plus, lung cancer of the same type at an early stage may have different associated biomarkers than at later stages. So one marker is unlikely to capture all of the different types, making it challenging to find biomarkers for each one of those subtypes of lung cancer, and then combine them into a single test whose utility has been rigorously demonstrated.

UALC: We’re very excited to be partnering with the Canary Foundation and the National Cancer Institute Early Detection Research Network (NCI-EDRN) in an initiative to find biomarkers in people who have never smoked. Can you tell us more about it?

Dr. Hanash: In 2009 the Canary Lung Team was awarded a 2-year $2 million grant from EDRN for a multi-institutional partnership project that emphasizes lung cancer among never-smokers. The NCI-EDRN is funding most of the tumor studies, and the Canary/Uniting team will provide funding for the cell culture studies.

Lung cancer among never-smokers is somewhat of a black box. Before we start developing tests for biomarkers, we have to understand the disease. In the first year of this project, we are assembling many different sets of data using lung cancer cell lines, tissue, and blood specimens, investigated by scientists at five of the nation's leading research institutions in a coordinated approach. Once we finish these initial studies, we can start zooming in on which characteristics might yield good biomarkers using our collective expertise. An important aspect of this work is that multiple technologies are being applied to the same sets of specimens with all resulting data deposited into a single repository for data integration. We’d like to identify biomarkers that can tell you if a person who is healthy and has never smoked is at risk for lung cancer. Then we want to identify biomarkers that actually detect lung cancer early in this group of people.

UALC: What do you see in the future?

Dr. Hanash: For the foreseeable future, once we have the biomarkers, we’ll still need imaging tests. It’s hard to imagine someone being treated for a cancer without looking at where the cancer is. But eventually, this may not be the case. Let’s say a test comes back positive and we know the patient has lung cancer at a very early stage. It could very well be that in the future, a vaccine could become available. You could use that vaccine without having seen the early stage cancer to prevent its further development. We’re being somewhat futuristic, but it certainly could happen in the next 10 years.

We are challenged by the heterogeneity of lung cancer, the different things that may make someone susceptible to develop lung cancer, the requirement that the test be simple but highly accurate, among others. If it was a piece of cake, it would have been done a long time ago. But we need to persevere and make sure we keep making progress, and keep our eyes on our goal.

Find out more about Uniting's commitment to the Canary Foundation.