KEY TAKEAWAYS
- The FANSS trial aimed to screen Asian female nonsmokers with LDCT chest scans to assess lung cancer screening feasibility.
- Eligible women aged 40-74 with Asian descent undergo a baseline LDCT chest scan and plasma-based cfDNA assay, followed by annual LDCT for two years.
- The study found that ACT-SOX was safe and showed long-term survival benefits in first-line advanced gastric/gastroesophageal adenocarcinoma.
Lung cancer (LC) is the leading cause of cancer death in Asian Americans; most are diagnosed at advanced or late stages. Approximately 60-80% of female LC patients(pts) in Asia are never smokers. Current lung cancer screening in the US is only offered to current or former smokers, but studies in Taiwan have shown that screening high-risk nonsmokers can detect LC earlier.
Researchers aimed to screen Asian female nonsmokers with low-dose CT(LDCT) chest scans to assess lung cancer screening feasibility.
The study is an IRB-approved, prospective multicenter (NYU, MGH, UCI). Inclusion criteria were women aged 40-74 who had never smoked or smoked <100 cigarettes in their lifetime and of Asian descent. Exclusion criteria were a history of LC or cancer treatment within 5 years. After informed consent, eligible pts have a shared decision discussion, followed by a baseline LDCT Chest scan (interpreted using Lung-RADS 1.1) and annual LDCT scans for two more years. A plasma-based assay by Delfi Diagnostics (Baltimore, MD), conducted at each scan, analyzes cell-free DNA (cfDNA) fragments for early cancer detection. A questionnaire on ethnicity, family history, and environmental exposures is collected at baseline.
Of about 222 enrolled pts, 201 underwent a baseline LDCT at NYU. Their ages ranged from 40 to 74 years, with a median age of 56.8. Among them, 83 individuals (41%) had a family history of LC. Of the 201 pts who completed the baseline LDCT, 87 (43%) were categorized as Lung-RADS 1, 101 (50%) as Lung-RADS 2, 6 (3%) as Lung-RADS 3, and 7 (3.5%) as Lung-RADS 4, 5 pts with Lung-RADS 3 and 3 with Lung-RADS 4 had solid, subsolid, or ground glass nodules larger than 6mm and were closely monitored. About 3 pts were diagnosed with invasive lung adenocarcinoma, resulting in an LC detection rate of 1.5%; 2 were in stage IIB, and one was in stage IIIC. These pts underwent surgical resection, tested positive for EGFR mutations, and received adjuvant osimertinib treatment. The analysis of cfDNA fragmentation profiles is currently ongoing.
The study showed the feasibility and promise of lung cancer screening in Asian female nonsmokers.
Source: https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.16_suppl.8510
Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT05164757
Elaine Shum, Wenyuan Li, Lecia V. Sequist, Sai-Hong Ignatius Ou, Judith D. Goldberg, Abraham Chachoua, and Kwok-Kin Wong. DOI: 10.1200/JCO.2023.41.16_suppl.8510 Journal of Clinical Oncology 41, no. 16_suppl (June 01, 2023) 8510-8510.
