Exploring the Potential of Non-Coding RNAs as Liquid Biopsy Biomarkers for Lung Cancer Screening: A Literature Review

SIMPLE SUMMARY: Low-dose CT scan screening will be widely implemented on a large-scale base, aiming to reduce lung cancer related mortality in the high risk smoking population as already reported in multiple trials, in several countries. Recent evidence has suggested that the identification of liquid biopsy biomarkers may improve its accuracy in lung cancer early detection, reducing the false positive rate as well as overdiagnosis issues and potentially addressing one of the major obstacles in the implementation of Low-dose CT scan alone in this context. RNAs, particularly non-coding RNAs, are for sure the most studied and promising circulating biomarkers in this setting. ABSTRACT: Lung cancer represent the leading cause of cancer mortality, so several efforts have been focused on the development of a screening program. To address the issue of high overdiagnosis and false positive rates associated to LDCT-based screening, there is a need for new diagnostic biomarkers, with liquid biopsy ncRNAs detection emerging as a promising approach. In this scenario, this work provides an updated summary of the literature evidence about the role of non-coding RNAs in lung cancer screening. A literature search on PubMed was performed including studies which investigated liquid biopsy non-coding RNAs biomarker lung cancer patients and a control cohort. Micro RNAs were the most widely studied biomarkers in this setting but some preliminary evidence was found also for other non-coding RNAs, suggesting that a multi-biomarker based liquid biopsy approach could enhance their efficacy in the screening context. However, further studies are needed in order to optimize detection techniques as well as diagnostic accuracy before introducing novel biomarkers in the early diagnosis setting.