The role of IGF-pathway biomarkers in determining risks, screening, and prognosis in lung cancer

Alexander W. Pohlman, Hita Moudgalya, Lia Jordano, Gabriela C. Lobato, David Gerard, Michael J. Liptay, Christopher W. Seder and Jeffrey A. Borgia _

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Oncotarget. 2022; 13:393-407. https://doi.org/10.18632/oncotarget.28202

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Alexander W. Pohlman1, Hita Moudgalya2, Lia Jordano3, Gabriela C. Lobato4, David Gerard2, Michael J. Liptay5, Christopher W. Seder5 and Jeffrey A. Borgia2,4,6

1 Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA

2 Department of Anatomy and Cell Biology, Rush University Medical Center, Chicago, IL 60612, USA

3 Department of General Surgery, Rush University Medical Center, Chicago, IL 60612, USA

4 Department of Biochemistry, Rush University Medical Center, Chicago, IL 60612, USA

5 Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL 60612, USA

6 Department of Pathology, Rush University Medical Center, Chicago, IL 60612, USA

Correspondence to:

Jeffrey A. Borgia, email: [email protected]

Keywords: IGF; lung cancer; biomarkers; screening; prognostication

Received: December 15, 2021     Accepted: February 07, 2022     Published: February 18, 2022

Copyright: © 2022 Pohlman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Detection rates of early-stage lung cancer are traditionally low, which contributes to inconsistent treatment responses and high rates of annual cancer deaths. Currently, low-dose computed tomography (LDCT) screening produces a high false discovery rate. This limitation has prompted research to identify biomarkers to more clearly define eligible patients for LDCT screening, differentiate indeterminate pulmonary nodules, and select individualized cancer therapy. Biomarkers within the Insulin-like Growth Factor (IGF) family have come to the forefront of this research.

Main Body: Multiple biomarkers within the IGF family have been investigated, most notably IGF-I and IGF binding protein 3. However, newer studies seek to expand this search to other molecules within the IGF axis. Certain studies have demonstrated these biomarkers are useful when used in combination with lung cancer screening, but other findings were not as conclusive, possibly owing to measurement bias and non-standardized assay techniques. Research also has suggested IGF biomarkers may be beneficial in the prognostication and subsequent treatment via systemic therapy. Despite these advances, additional knowledge of complex regulatory mechanisms inherent to this system are necessary to more fully harness the potential clinical utility for diagnostic and therapeutic purposes.

Conclusions: The IGF system likely plays a role in multiple phases of lung cancer; however, there is a surplus of conflicting data, especially prior to development of the disease and during early stages of detection. IGF biomarkers may be valuable in the screening, prognosis, and treatment of lung cancer, though their exact application requires further study.

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