Non-Invasive Biomarkers for Early Lung Cancer Detection

SIMPLE SUMMARY: Lung cancer remains the first cause of cancer worldwide. The main reason for this high rate of death from lung cancer is dissemination of the disease at the time of presentation to hospital due to late diagnosis. The aim of this article is to review and assess the effectiveness of different techniques, currently in use and that are upcoming, in early detection of lung cancer. We will present and evaluate the principles of developing such techniques and how to overcome challenges frequently facing researchers in the field of early lung cancer detection. Improvement in early detection would lower the rate of death and the societal burden of this often lethal condition. ABSTRACT: Worldwide, lung cancer (LC) is the most common cause of cancer death, and any delay in the detection of new and relapsed disease serves as a major factor for a significant proportion of LC morbidity and mortality. Though invasive methods such as tissue biopsy are considered the gold standard for diagnosis and disease monitoring, they have several limitations. Therefore, there is an urgent need to identify and validate non-invasive biomarkers for the early diagnosis, prognosis, and treatment of lung cancer for improved patient management. Despite recent progress in the identification of non-invasive biomarkers, currently, there is a shortage of reliable and accessible biomarkers demonstrating high sensitivity and specificity for LC detection. In this review, we aim to cover the latest developments in the field, including the utility of biomarkers that are currently used in LC screening and diagnosis. We comment on their limitations and summarise the findings and developmental stages of potential molecular contenders such as microRNAs, circulating tumour DNA, and methylation markers. Furthermore, we summarise research challenges in the development of biomarkers used for screening purposes and the potential clinical applications of newly discovered biomarkers.