142 Established and emerging less-invasive biomarkers and technologies for lung cancer diagnostic screening: Puerto Rican context

Objectives/Goals: Lung cancer remains one of the leading causes of cancer-related mortality, primarily due to late-stage diagnosis. This project explores both universal technical limitations and region-specific socioeconomic barriers of screening strategies and the importance of novel biomarkers within the Puerto Rican healthcare context. Methods/Study Population: We conducted a comprehensive review of peer-reviewed literature of lung cancer detection strategies, ranging from the current clinical standard – LDCT – to emerging non-invasive technologies, including serum protein biomarkers (CYFRA 21-1, CEA, SCC, NSE, ProGRP, HE4), exhaled breath analysis (nitric oxide/nitrites and volatile organic compounds), and liquid biopsies (ctDNA). Each approach was examined for its technical constraints and the implementation challenges it poses in Puerto Rico, such as limited access, high cost, and logistical barriers. Results/Anticipated Results: While LDCT remains the global gold standard and has demonstrated mortality reduction, its application in Puerto Rico is hindered by false positives and limited accessibility. Novel non-invasive biomarkers CYFRA 21-1, CEA, SCC, NSE, ProGRP, HE4, nitric oxide/nitrites, volatile organic compounds, and ctDNA) show significant potential but currently suffer from inconsistent sensitivity and specificity. We are conducting an ongoing study recruiting newly diagnosed lung cancer patients to quantify these biomarkers and compare them with healthy controls. Discussion/Significance of Impact: Developing an integrated, multi-marker, non-invasive diagnostic panel represents a promising strategy to overcome healthcare disparities, enhance early detection, and ultimately reduce lung cancer mortality in Puerto Rico.