Registry and follow up of indeterminate nodules using the EarlyCDT

Computed tomography (CT) is routinely performed to study various  respiratory ailments, including lung cancer. The routine use of CT is leading to the detection of an increasing number of pulmonary nodules. Even in high-risk patients, most of these nodules are benign, but their detection alters patients' quality of life  since it can lead to invasive tests or uncertainty during radiological follow-up.

Current recommendations regarding the management of nodules that measure between 6 and 15 mm in diameter vary between scientific societies. Diagnostic options include CT follow-up, characterization of the nodule by PET CT, or biopsy, depending on the nodule's characteristics  (size, spiculation, location) and the patient's risk factors (age, smoking, family history). The PET CT scan, essential in the staging of patients with lung cancer or the characterization of nodules larger than 15 mm in diameter, lacks sufficient sensitivity and specificity for smaller nodules. Faced with an expectant attitude, the speed of duplication of the nodule in 3 to 6 months is usually the only criterion used to recommend a biopsy performance.

In this context, the use of biomarkers (circulating DNA, microRNA or autoantibodies) associated with the presence of lung cancer is being investigated. The EarlyCDT-Lung test has been validated for the characterization of indeterminate pulmonary nodules. It is a blood test that identifies antibodies against a panel of seven tumour antigens related to this neoplasm. The test's accuracy is 92%, with an average sensitivity and specificity of 41% and 93%, respectively, for lung cancer.