Novel lung cancer screening platform uses inhaled sensors and urine test

A team of researchers has developed a new platform to screen for lung cancer, with the approach involving inhaling tiny sensors, collecting a urine sample, and then analysing it using a paper strip.

Named PATROL (point-of-care aerosolizable nanosensors with tumour-responsive oligonucleotide barcodes), the screening platform is noninvasive and does away with needles and imaging exams. This work was geared toward creating a point-of-care detection platform that would make lung cancer screening accessible, especially in low-resource areas where a low-dose computed tomography (CT) scanner might not be widely available.

“Our goal was to provide a method that can detect cancer with high specificity and sensitivity, and also lower the threshold for accessibility, so that hopefully we can improve the resource disparity and inequity in early detection of lung cancer,” said one of the lead researchers Qian Zhong, PhD, a research scientist at the Massachusetts Institute of Technology (MIT) in Cambridge, Massachusetts, US, in a news release.

PATROL uses polymer nanosensors formulated as aerosols that can be delivered via nebulizers or as dry powder that can be delivered via inhalers. These nanosensors integrate DNA barcodes that are released upon encountering cancer-linked enzymes, known as proteases, and eventually excreted from the body through urine.

The urine sample is then tested using a multiplexable paper-based lateral flow assay, which can check for up to four different DNA barcodes, each linked to a specific type of protease. The results can be read in about 20 minutes at room temperature.

“We were really pushing this assay to be point-of-care available in a low-resource setting, so the idea was to not do any sample processing, not do any amplification, just to be able to put the sample right on the paper and read it out in 20 minutes,” according to senior researcher Prof Sangeeta Bhatia, a member of MIT’s Koch Institute for Integrative Cancer Research and the Institute for Medical Engineering and Science.

Animal study

Zhong and Bhatia, along with the rest of their team, tested the diagnostic accuracy of PATROL in mice that were genetically engineered to develop lung tumours similar to those seen in humans. The test was performed after the tumours had been growing for about 7.5 weeks, a time point that likely corresponds to early stage (stage 1 or 2) lung cancer in humans.

The PATROL platform was able to detect grade I/II lung adenocarcinoma in an autochthonous model with high sensitivity and specificity (area under the curve, 0.93). [Sci Adv 2024;doi:10.1126/sciadv.adj9591]

The next step in the research is to conduct clinical trials in human patients, according to the researchers, who acknowledged that more sensors might be needed for the test to work in humans. One possible solution would be to use multiple test strips at once, they added.

“The idea would be you come in and then you get an answer about whether you need a follow-up test or not, and we could get patients who have early lesions into the system so that they could get curative surgery or lifesaving medicines,” Bhatia said.