1. Evaluation of pre-diagnostic blood protein measurements for predicting survival after lung cancer diagnosis.
- Author
-
Feng X, Muller DC, Zahed H, Alcala K, Guida F, Smith-Byrne K, Yuan JM, Koh WP, Wang R, Milne RL, Bassett JK, Langhammer A, Hveem K, Stevens VL, Wang Y, Johansson M, Tjønneland A, Tumino R, Sheikh M, Johansson M, and Robbins HA
- Subjects
- Humans, Prognosis, Proportional Hazards Models, France, Sweden, Antigens, Neoplasm, Cell Adhesion Molecules, Lung Neoplasms diagnosis
- Abstract
Background: To evaluate whether circulating proteins are associated with survival after lung cancer diagnosis, and whether they can improve prediction of prognosis., Methods: We measured up to 1159 proteins in blood samples from 708 participants in 6 cohorts. Samples were collected within 3 years prior to lung cancer diagnosis. We used Cox proportional hazards models to identify proteins associated with overall mortality after lung cancer diagnosis. To evaluate model performance, we used a round-robin approach in which models were fit in 5 cohorts and evaluated in the 6th cohort. Specifically, we fit a model including 5 proteins and clinical parameters and compared its performance with clinical parameters only., Findings: There were 86 proteins nominally associated with mortality (p < 0.05), but only CDCP1 remained statistically significant after accounting for multiple testing (hazard ratio per standard deviation: 1.19, 95% CI: 1.10-1.30, unadjusted p = 0.00004). The external C-index for the protein-based model was 0.63 (95% CI: 0.61-0.66), compared with 0.62 (95% CI: 0.59-0.64) for the model with clinical parameters only. Inclusion of proteins did not provide a statistically significant improvement in discrimination (C-index difference: 0.015, 95% CI: -0.003 to 0.035)., Interpretation: Blood proteins measured within 3 years prior to lung cancer diagnosis were not strongly associated with lung cancer survival, nor did they importantly improve prediction of prognosis beyond clinical information., Funding: No explicit funding for this study. Authors and data collection supported by the US National Cancer Institute (U19CA203654), INCA (France, 2019-1-TABAC-01), Cancer Research Foundation of Northern Sweden (AMP19-962), and Swedish Department of Health Ministry., Competing Interests: Declaration of interests Jian-Min Yuan has a declaration on NIH grant funding, and the other authors have no conflicts of interest., (Copyright © 2023 World Health Organization. Published by Elsevier B.V. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF