The future is here now: Use of proteomic testing in pulmonary nodule management in an underserved population in Brooklyn, NY.

Abstract

e22513 Background: NodifyLung proteomic testing is designed to help risk stratify low to moderate risk pulmonary nodules characterized by 5-65% risk of malignanc as per the Mayo Solitary Pulmonary Nodule (SPN) calculator. This study reviews the utilization of NodifyLung and possible clinical implications in a new lung cancer screening program at an East Brooklyn safety-net hospital. Methods: A retrospective chart analysis was conducted on patients who underwent NodifyLung testing at Wyckoff Heights Medical Center, a New York City safety-net hospital from August 2023 to December 2024 with CT-detected solitary pulmonary nodule (SPN) (ICD10: R91.1) or multiple pulmonary nodules (ICD10: R91.8) sized 4-30mm. Demographic and clinical characteristics (age, sex, smoking history, nodule size, speculation, and lobe location) were collected. Descriptive statistics summarized patient demographics, nodule characteristics, and NodifyLung test results. Emphasis of observation was placed on patients who has a “positive” result on the proteomic testing. Results: Of the 103 patients included in the study, 56 (54.4%) were female, 82 (79.6%) were current/former smokers, and 88 (85.4%) had no prior history of cancer. The mean age was 65 years. The average nodule size was 11.7 ± 5.6 mm, with 53 (51.5%) located in the upper lobes and 42 (40.8%) spiculated. There were a total of 10 (9.7%) which resulted as moderate risk and 9 (8.7%) at high risk. In the High/Moderate group, 5 (26.3%) were lost to follow-up, 2 (10.5%) had pending results, 2 (10.5%) biopsies were negative (one suggesting sarcoidosis), and 1 (5.26%) was positive for malignancy, and 8 (42.1%) showed stable finding at short term follow up, and 1 (5.2%) showed worsened imaging findings. Conclusions: Proteomic testing is a novel tool to help aid in pulmonary nodule risk stratification. Out abstract highlights the challenges of underserved populations. In theory such novel testing may increase patient compliance, may help guide physicians to repeat imaging earlier and on the flip side prevent unnecessary procedures. Biomarker proteomic testing on lung nodule risk stratification and clinical monitoring results. Follow up status until December 2024 NodifyLung CDT test Non-Significant Lung-Associated Disease (NSALD) Moderate/High (n, %) XL2 testing: Likely Benign/Reduced Risk (n, %) XL2 testing: Indeterminate (n, %) Lost to follow up 18 (29.0) 12 (54.5) 5 (26.3) Pending follow up 1 (1.6) 1 (4.5) 2 (10.5) Biopsy/bronchoscopy Positive 2 (3.2) 2 (9.1) 1 (5.2) Negative 1 (1.7) 0 2 (10.5) Imaging Stable 29 (46.8) 5 (22.7) 8 (42.1) Decrease 6 (9.7) 0 0 Worse 5 (8.1) 2 (9.1) 1 (5.2) Total 62 (100) 22 (100) 19 (100)