Predicting what will happen to patients with fluid around their lung linked to lung cancer

Lung cancer is a leading cause of cancer death.

Some patients with lung cancer develop a build-up of fluid around their lungs, called a malignant pleural effusion. This fluid can cause breathlessness and usually means the cancer is advanced. However, the pleural fluid is often easy to collect using a simple bedside procedure. This makes it a useful and accessible source of information about the cancer.

We can use samples of pleural fluid from patients with a malignant pleural effusion to measure DNA methylation (DNAm). This is a chemical change to DNA that affects how genes are switched on and off.

Changes in DNAm are known to play an important role in cancer. New technologies now allow us to measure DNAm across the whole genome. This can help identify patterns linked to how a cancer behaves, how patients will respond to treatment, and how long they will survive.

Project aims

This project will test whether DNAm patterns in pleural fluid can predict survival, disease progression, and response to treatment in patients with pleural effusion caused by lung adenocarcinoma.

100 patients from around the UK will take part in the study, over 21 months. At the start of the study, and again after 3 and 6 months, we will collect pleural fluid – if it is safe to do so – and blood samples. We will also record important clinical information, for example how patients respond to treatment and how long they survive.

We will extract and analyse DNA from pleural fluid samples. We will then use machine learning to identify patterns in DNAm that best predict how patients’ health changes.

What we hope to achieve

In the short term, we aim to identify patterns in DNAm which are linked to how lung cancer progresses, how patients respond to treatment and how long they survive. This will help us design a larger study across several hospitals.

In the longer term, we hope to develop and validate a simple bedside test for patients with malignant pleural effusion, using DNAm to help predict how their disease will progress. This could give patients a clearer idea about their future and help healthcare professionals make decisions about treatment.