• Edwin J Ostrin, Leonidas E Bantis, David O Wilson, Nikul Patel, Renwei Wang, Deepali Kundnani, Jennifer Adams-Haduch, Jennifer B Dennison, Johannes F Fahrmann, Hsienchang Thomas Chiu, Adi Gazdar, Ziding Feng, Jian-Min Yuan, and Samir M Hanash.
• Department of General Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Pulmonary Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: ejostrin@mdanderson.org.
• J Thorac Oncol. 2021 Feb 1; 16 (2): 228-236.

RationaleThe workup and longitudinal monitoring for subjects presenting with pulmonary nodules is a pressing clinical problem. A blood-based biomarker panel potentially has utility for identifying subjects at higher risk for harboring a malignant nodule for whom additional workup would be indicated or subjects at reduced risk for whom imaging-based follow-up would be indicated.ObjectivesTo assess whether a previously described four-protein biomarker panel, reported to improve assessment of lung cancer risk compared with a smoking-based lung cancer risk model, can provide discrimination between benign and malignant indeterminate pulmonary nodules.MethodsA previously validated multiplex enzyme-linked immunoassay was performed on matched case and control samples from each cohort.MeasurementsThe biomarker panel was tested in two case-control cohorts of patients presenting with indeterminate pulmonary nodules at the University of Pittsburgh Medical Center and the University of Texas Southwestern.Main ResultsIn both cohorts, the biomarker panel resulted in improved prediction of lung cancer risk over a model on the basis of nodule size alone. Of particular note, the addition of the marker panel to nodule size greatly improved sensitivity at a high specificity in both cohorts.ConclusionsA four-marker biomarker panel, previously validated to improve lung cancer risk prediction, was found to also have utility in distinguishing benign from malignant indeterminate pulmonary nodules. Its performance in improving sensitivity at a high specificity indicates potential utility of the marker panel in assessing likelihood of malignancy in otherwise indeterminate nodules.Copyright © 2020 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

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