Lung cancer is known to be the deadliest cancer worldwide, and there are many cases where cancer relapses or metastasizes even in the early stages. With the urgent need for the development of new treatment methods to detect and diagnose lung cancer early, international researchers have recently developed a tool that can predict patients' survival chances and treatment responses, providing personalized treatment strategies.
Researchers from the Francis Crick Institute in the United Kingdom and University College London (UCL) announced that they have developed the 'Oracle (ORACLE)' testing method, which can more accurately predict the survival rates of patients with early-stage lung cancer than existing clinical criteria, and tested it on actual patients. The research results were published in the international journal 'Nature Cancer' on the 9th.
Lung cancer is the leading cause of cancer-related deaths globally and is considered one of the most difficult cancers to treat. Patients with stage 1 lung cancer can sometimes be treated solely through surgery, but 25% of stage 1 patients experience cancer recurrence. In this situation, the current clinical criteria were found to be inadequate in accurately predicting the prognosis of patients with stage 1 lung cancer, necessitating improvement.
The research team developed the diagnostic tool Oracle in 2019. Oracle predicts survival chances and treatment responsiveness by analyzing the expression levels of specific genes from various regions of tumor samples. Existing methods often analyze less than 1% of tumor samples, missing genetic differences that vary by tumor location, but Oracle addresses this issue, providing more comprehensive information.
In this study, the Oracle test was conducted on 158 lung cancer patients. As a result, Oracle was able to predict patient survival rates better than existing clinical criteria. Particularly for patients with stage 1 lung cancer, Oracle enabled the prediction of the risk of cancer recurrence and identified patients who may require adjuvant chemotherapy in addition to surgery.
The research team confirmed that patients with high Oracle test scores tend to have unstable DNA. The more unstable the DNA, the faster the tumor tends to grow and the higher the likelihood of metastasizing to other areas. Therefore, platinum-based drugs that directly damage DNA are expected to show high effectiveness. The Oracle test not only predicts survival rates but also assesses the responsiveness to specific chemotherapy drugs, enabling personalized treatment for patients.
Professor Charles Swanton from the Francis Crick Institute, who led the research, noted, 'Lung cancer is a major cause of cancer-related deaths worldwide, and better biological markers are needed to predict effective treatments and outcomes.' He emphasized, 'If the Oracle test is introduced into clinical practice, it could dramatically improve patient treatment outcomes.' The research team plans to conduct further studies to verify whether the Oracle test can exhibit the same performance in large patient populations.
Dani Edmonds, a manager at Cancer Research UK, said, 'Survival rates for cancer have doubled over the past 50 years, but intractable cancers like lung cancer remain a challenge.' She added, 'Tests like Oracle could enable personalized treatment strategies that could improve patients' lives.'
Reference materials
Nature Cancer (2025), DOI: https://doi.org/10.1038/s43018-024-00883-1