The telltale lung: A new clue to identify, treat early-stage lung cancer

Studying the body's smallest bacteria gave UIC researchers an idea for how to catch lung cancer at its source.

Led by oncologist and cancer researcher Dr. Frank Weinberg, the scientists looked at lung cells and fluids from 20 cancer patients. They noticed the patients' lungs shared a unique combination of molecules. That combination, they realized, is a telltale warning sign that can help them detect, treat and, perhaps, even prevent lung cancer in its earliest stages.

"We don't have any preventative therapies for lung cancer. We want to detect cancer early, and we want to prevent it from happening. This pathway we've detected may do both," said Weinberg, who teaches in the College of Medicine and is affiliated with the University of Illinois Cancer Center.

Lung cancer is the leading cause of cancer death in the United States and worldwide. When people undergo lung cancer treatment, the microorganisms inside our lungs - collectively called the microbiome - communicate with our immune systems to process the treatment. But little is known about how our microbiomes interact with cancer itself.

In a new study, Weinberg and his team collected fluid and cell samples from 20 patients with early-stage lung cancer during routine bronchoscopy procedures.

"But instead of just sampling from the cancer-affected regions of the lungs, which is the standard, we took samples from three sites to get a more holistic picture," Weinberg said.

The researchers analyzed three elements in the samples: microorganisms, metabolites (which cells use to produce energy and communicate) and cytokines (which immune cells produce to communicate with one another). Their investigation was open-ended, aiming to determine which - if any - of these factors influenced cancer development.

"I look at the patient first," said Weinberg, who is also a clinician. "That's what drives the mechanistic validation. I'm basing my science on the subject first, not the other way around."

The researchers observed that in tumor-affected areas, there were higher amounts of some fatty acids and cytokines (the inter-immune -system messaging service) than in healthy areas in the lungs. Additionally, the relationship between fatty acids and immune cells, called macrophages, was disrupted in active tumor areas.

"All of these observations add up to a potential biomarker, or biological clue, that a patient may go on to develop lung cancer," Weinberg said. "We're using information from the immune system, the metabolism and the lung environment to create a big picture of what cancer looks like."

Notably, the researchers also analyzed blood samples from early- and late-stage lung cancer patients. These samples also displayed distinct warning signs, a finding that will give future patients a quicker, easier way to test for lung cancer.

Coauthor Amrita Roy said the biomarker may also be a cause of lung cancer, not simply a sign of it, opening new avenues for early detection and prevention.

"This study lays the groundwork for biomarker-based detection strategies capable of identifying high-risk individuals at stages that remain undetectable by conventional screening methods," said Roy, a research assistant professor in the College of Medicine.

This study appears in Cancer Prevention Research.

Additional UIC authors include Martin Davis, Kathy M. De La Torre and Alicia Hulbert.