2026 IASLC CT Screening and Early Detection Symposium-WS02.01 - Talk 1: Foundations of Biomarker Research in Lung Cancer Screening

Pdf Summary

The presentation outlines key principles for developing biomarker tests for lung cancer screening, especially for use in low-dose CT (LDCT) programs. The main potential uses of biomarkers are to personalize screening intervals, improve risk assessment and eligibility decisions, and help manage lung nodules. However, many promising biomarkers never reach clinical use because studies are not designed with translation in mind.<br /><br />The speaker emphasizes five principles for successful predictive biomarker development:  <br />1. Use pre-diagnostic samples from the target population.  <br />2. Ensure sufficient sample size.  <br />3. Build prediction algorithms using study designs that mimic the real screening population.  <br />4. Use independent training and testing samples.  <br />5. Demonstrate improvement over the best available tool.<br /><br />The Lung Cancer Cohort Consortium (LC3), involving 26 population cohorts across 16 countries, provides a large resource for this work, with millions of participants and tens of thousands of incident lung cancer cases. The presentation describes nested case-control and case-cohort designs using blood samples collected up to three years before diagnosis.<br /><br />A major example is the INTEGRAL panel, designed for dual purposes: risk stratification and nodule malignancy discrimination. It uses protein biomarkers measured in blood and is being developed through both discovery and validation studies. Sample size needs depend on biomarker effect sizes, the number of markers, and model complexity; simulations suggest 500–600 samples may be enough for some high-dimensional proteomic prediction tasks.<br /><br />Overall, the presentation argues that robust biomarker translation requires careful study design, appropriate cohorts, and proof that the biomarker adds value beyond existing screening tools.

Asset Subtitle

Mattias Johansson

Meta Tag

Concept Biomarker

Concept Chest Screening

Concept Predictive Biomarker Testing

Concept Target Population

Concept Lung Cancer Screening CT

Speaker Mattias Johansson

Keywords

lung cancer screening

biomarkers

low-dose CT

risk stratification

predictive biomarker development

Lung Cancer Cohort Consortium

nested case-control

case-cohort design

INTEGRAL panel

protein biomarkers

Biomarker

Chest Screening

Predictive Biomarker Testing

Target Population

Lung Cancer Screening CT

Mattias Johansson