Biomarkers are underutilized in precision lung medicine despite an abundance of available biomarker tests, according to an article published in the American Journal of Respiratory and Critical Care Medicine. This underscores the need for further research into the cost-effectiveness, generalizability, and utility of biomarkers in clinical settings.

This study included research and clinical professionals with diverse skill sets in precision medicine from the National Heart, Lung, and Blood Institute (NHLBI) and the American Thoracic Society (ATS). The group examined current practices for using biomarker tests in the diagnosis of lung diseases. A list of biomarkers was gathered using PubMed for diseases including pulmonary arterial hypertension, asthma, sepsis, cystic fibrosis, lung cancer, idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, and acute respiratory distress syndrome. In conducting this research, investigators summarized evidence corresponding to each condition. Knowledge gaps were identified that needed further research.

Biomarker tests vary by their corresponding condition. Certain conditions such as lung cancer have a wide range of prognostic biomarkers, and biomarker tests represent potential for greatly improved care in lung diseases. One issue lies in translating biomarkers to implementable tests. Further effort needs to be undertaken to fund research into more biomarkers, identify clinical needs, perform studies to validate and analyze biomarker tests, and advocate for the adoption of tests with reliable clinical applicability. Providers also need training to build confidence in genomics as well as knowledge of when to use biomarker tests. Platforms such as large biobanks for quickly disseminating new information to healthcare professionals would aid in this effort.

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The researchers concluded that “[d]espite notable advances in lung precision medicine, with thousands of biomarker tests either available or under development for several lung diseases, few biomarkers are in widespread clinical use. This ATS/NHLBI Research Statement summarizes the process of developing biomarkers, reviews current biomarkers for various pulmonary diseases, outlines barriers that must be overcome, and suggests research priorities to achieve the promises of lung precision medicine.”

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Disclosures: Several authors report associations with pharmaceutical companies. For a full list of author disclosures, please see the reference.


Chen Wu A, Kiley JP, Noel PJ, et al; on behalf of the American Thoracic Society Assembly on Behavioral Science and Health Services Research, and the Section on Genetics and Genomics. Current status and future opportunities in lung precision medicine research with a focus on biomarkers. An American Thoracic Society/National Heart Lung, and Blood Institute Research Statement. Am J Respir Crit Care Med. 2018;198(12):e116-136.