Late diagnosis and lack of reliable prognostic outcome predictions are important unmet clinical needs in lung cancer. Reasons for our inability to generate reliable diagnostic, prognostic and/or predictive biomarkers are the incomplete understanding of cancer progression, especially metastatic spread. For a cancer to spread from the primary site to distant organs, a large number of essential steps have to be overcome. We, and others, showed that cancer-secreted factors, including extracellular vesicles (EVs), are mediators of creating immune-suppressed, permissive environments (pre-metastatic niches) at distant organs before the arrival of cancer cells.
In this presentation, I will summarize the research approaches in the area of cancer-derived EVs undertaken by my group. I will discuss novel data on how analysing the protein content of cancer-derived EVs allows us to develop a blood-based, multi-protein biomarker for the early detection of NSCLC in patient cohorts. Importantly, this biomarker is capable of detecting stage I disease. Furthermore, in a prospective clinical trial, it is capable of distinguishing benign and malignant lung conditions accurately. I will additionally show intriguing clinical data on how further evaluation of the blood-based EVs is capable of prognosticating the outcome of NSCLC patients at baseline.