Genomic Nasal Swab to Help Determine Risk of Lung Cancer

A genomic nasal swab test can determine lung cancer risk, with high accuracy, in individuals who smoke or have previously smoked, according to a study led by Carla R. Lamb, MD.

Lamb et al used machine learning to train a classifier using genomic and clinical features on 1120 patients with either benign or malignant pulmonary nodules. The classifier was designed to yield low-, intermediate-, and high-risk categories.

“Accurate assessment of the probability of lung cancer is critical in patients with pulmonary nodules to help guide decision-making,” the researchers wrote.

The nasal epithelial cells used to develop the classifier were from patients with a pulmonary nodule that was 30 mm or less. An independent set of 312 patients with lung cancer was used to validate the classifier. Of these patients, 63 had a history of cancer other than in the lung.

Researchers found that the classifier showed a specificity of 90% and a sensitivity of 58% in the high-risk category. For low-risk classification, specificity was 42% and sensitivity was 96%. Furthermore, sensitivity was similar across stages of NSCLC.

In the patients with a prior cancer history, an analysis of the classifier showed similar performance. The same was true for patients with light versus heavy smoking burden and patients eligible for lung cancer screening versus those who were not.

“Classifier-guided decision-making could lead to fewer diagnostic procedures in patients without cancer and more timely treatment in patients with lung cancer,” the researchers concluded.