New blood test detects early lung damage in cancer patients on targeted therapy

New study introduces a simple blood test to detect early lung damage in cancer patients receiving novel therapy with antibody-drug conjugates (ADCs), which can sometimes cause serious, even fatal, lung disease (ILD). By analyzing specific markers in circulating DNA, this test provides a non-invasive way to monitor patients for lung complications without relying solely on imaging scans. This advancement is important because it could help doctors detect and manage damage sooner, improving safety for patients on powerful cancer drugs and making ongoing monitoring easier and more accessible.

A team of researchers led by Dr. Albert Grinshpun from the Sharett Institute of Oncology at Hadassah-Hebrew University Medical Center and Dr. Ori Fridlich from Center for Liquid Biopsy at the Department of Pediatric Hemato-Oncology, Hadassah-Hebrew University Medical Center have applied a novel blood test that can detect early signs of potentially fatal lung damage in cancer patients taking antibody-drug conjugates (ADCs). This breakthrough method aims to offer a safer, simpler way to monitor patients for drug-induced lung disease, potentially reducing the need for frequent scans.

ADCs, including the widely used cancer drug Enhertu (trastuzumab deruxtecan), represent a new wave of targeted therapies. However, these drugs can sometimes cause interstitial lung disease (ILD)—a serious condition that can lead to significant lung damage if left untreated. This study demonstrates that by analyzing specific markers in blood samples, doctors can spot early signs of lung damage caused by these drugs. This concept is based on the seminal work originated by Prof. Yuval Dor and Ruth Shemer from the Faculty of Medicine, The Hebrew University.

In this study, researchers retrospectively examined blood from patients with metastatic HER2-positive cancers who were treated with Enhertu and a minority of them developed lung damage during Enhertu treatment. By analyzing these samples, the team detected markers of lung damage that matched symptoms confirmed by medical imaging.

ADCs and other novel cancer therapies are powerful treatments, but monitoring their side effects can be complex. This blood test could offer a low-cost, non-invasive way to detect lung damage early on, helping patients get timely care without relying solely on scans."

Dr. Albert Grinshpun, Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center

This discovery offers a new approach for monitoring lung health in patients taking ADCs, providing a promising, accessible option for early detection and monitoring. The research team aims to develop this method further for broader clinical use. 

Source:
Journal reference:

Grinshpun, A., et al. (2024). Detection of antibody–drug conjugate-induced interstitial lung disease using circulating cell-free DNA. ESMO Open. doi.org/10.1016/j.esmoop.2024.103715.

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