WCLC 2025 - Posters & ePosters-P2.06.97 Monitoring the Risk of Second Primaries Through Blood miRNA Testing: Follow-Up of the BioMILD Lung Cancer Screening Trial

P2.06.97 Monitoring the Risk of Second Primaries Through Blood miRNA Testing: Follow-Up of the BioMILD Lung Cancer Screening Trial

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The BioMILD lung cancer screening trial enrolled 4,119 heavy smokers, integrating low-dose CT (LDCT) with a plasma 24-miRNA classifier (MSC test) to enhance prediction of lung cancer (LC) incidence and mortality. This follow-up study focused on evaluating the MSC test's utility in monitoring disease status post-curative surgery in 98 stage I LC patients from the BioMILD cohort over more than 10 years.<br /><br />A total of 776 MSC tests were analyzed longitudinally via RT-qPCR: 96 at initial LC diagnosis and 680 during post-surgery follow-up (median 7 samples per patient). The study aimed to detect changes in MSC risk profiles that could signal second primary lung tumors or death.<br /><br />Results showed that post-surgery, approximately 47% of MSC tests were positive (MSC+), with distinct differences based on patient outcomes. Among patients who developed a second primary LC (17 individuals), 64.7% had positive MSC tests post-intervention, compared to 34.6% positivity in those without second LC, indicating a significant association (p=0.021). Longitudinal analysis revealed that MSC positivity increased markedly in the 6 months to 3 years before diagnosis of a second LC, ranging from 30% to about 34% positive tests in that window, compared to roughly 50% positivity in disease-free individuals.<br /><br />These findings suggest that dynamic monitoring of the MSC miRNA profile in blood plasma can serve as a sensitive biomarker to detect second primary lung cancers earlier during surveillance after initial surgery. Therefore, the MSC test enhances current lung cancer follow-up protocols by identifying patients at increased risk of recurrence or new primary tumors, potentially guiding more tailored management and improving survival outcomes.

Asset Subtitle

Gabriella Sozzi

Meta Tag

Speaker Gabriella Sozzi

Topic Pathology and Biomarkers

Keywords

BioMILD trial

lung cancer screening

heavy smokers

low-dose CT

plasma 24-miRNA classifier

MSC test

post-surgery monitoring

second primary lung cancer

longitudinal RT-qPCR analysis

lung cancer recurrence detection