Noninvasive advanced image analysis may improve care for lung cancer patients

Lung cancer patients could receive more precise treatment, and their progress could be better tracked by using a new high-tech method of non-invasive medical imaging analysis, according to a new study.

Genetic changes increasingly are recognized as driving cancer development. But obtaining evidence of these changes usually requires a biopsy, which can be problematic for sensitive regions of the body such as the lungs.

Based on a review of 48 patients with non-small cell lung cancer (NSCLC), the study found that by scanning their tumor cells using quantitative computed tomography-based texture analysis (QTA), researchers could determine with nearly 90% accuracy whether the patient's tumor had a cancer-causing K-ras gene mutation. The study was published in PLOS ONE (2014; doi:10.1371/journal.pone.0100244).

This Arizona study was led by investigators at the Translational Genomics Research Institute (TGen) in Phoenix, the Virginia G. Piper Cancer Center at Scottsdale Healthcare, and Cancer Treatment Centers of America (CTCA) in Goodyear.

NSCLC represents more than 85% of all lung cancers, which will kill an estimated 159,000 Americans this year, making it the leading cause of cancer-related death. Its 5-year survival rate is less than 10%.

QTA was shown to be an accurate and noninvasive alternative to surgical biopsy and other invasive means of collecting and analyzing biological samples, the study said. This method of making genomic distinctions may help physicians determine the best type of treatment to administer to each patient.

"The ability to rapidly and noninvasively characterize NSCLC tumors would be a great asset to clinical oncologists," said lead author Glen Weiss, MD, MBA, Director of Clinical Research and Medical Oncologist at Cancer Treatment Centers of America's Western Regional Medical Center in Phoenix, and a Clinical Associate Professor in TGen's Cancer and Cell Biology Division.

"QTA applied to molecularly defined NSCLC cases may have a broader application to precision medicine by offering a non-invasive way of identifying the best therapies for each patient," said Weiss. Weiss said future studies using QTA also could help identify other genomic subtypes of NSCLC.

"Noninvasive characterization of a tumor's molecular features could enhance treatment management. Noninvasive QTA can differentiate the presence of K-ras mutation from pan-wildtype NSCLC," said senior author Ronald Korn, MD, PhD, Medical Director of Scottsdale Healthcare's Virginia G. Piper Cancer Center. Korn also is CEO and Medical Director of Imaging Endpoints, a leading imaging core lab that provides centralized image handling and advanced image interpretations for clinical trials.

This study was supported by the TGen Foundation, the Scottsdale Healthcare Foundation, the Flinn Foundation, and the United Kingdom Department of Health. Sequenom Inc. provided the LungCarta Panel test analysis.

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