Background: Early detection of lung cancer is extremely important for timely and effective therapeutic interventions to increase the survival rate of patients. Emerging evidence suggests that tumor-derived small extracellular vesicle (sEV) cargo may serve as cancer-specific biomarkers. We previously reported the identification of GRIP and coiled-coil domain-containing 2-enriched sEV (sEV-GCC2) as a promising biomarker for lung adenocarcinoma in a pilot study. In this multicenter study, we explored the diagnostic and therapeutic potential of sEV-GCC2 in early-stage lung adenocarcinoma.

Methods: A total of 470 blood plasma samples (150 healthy controls and 320 patients with lung adenocarcinoma) were retrospectively obtained from five institutions. sEVs were isolated by size exclusion chromatography and sEV-GCC2 was quantified by enzyme-linked immunosorbent assay. Effect of sEV-GCC2 on lung cancer cell proliferation was investigated in vitro and in vivo.

Results: sEV-GCC2 concentration was significantly higher in patients than that in controls with an area under the curve (AUC) of 0.856 (95% confidence interval [CI], 0.820-0.886). In patients at TisN0-T1miN0 stages vs controls, the AUC was 0.802 (95% CI, 0.734-0.859). The association between sEV-GCC2 and lung adenocarcinoma remained after adjustment for pathological TNM stage and tumor location in the left lower lobe. Immunohistochemical staining revealed that GCC2 expression was significantly higher in lung adenocarcinoma tissues than in the controls (p < 0.001). Furthermore, sEV-GCC2 enhanced cancer cell proliferation and accelerated tumor growth and lymph node metastasis.

Conclusions: We identified sEV-GCC2 as a potential diagnostic marker for very early-stage lung cancer. sEV-GCC2 represents a promising therapeutic target for lung adenocarcinoma and may be quantified as key molecules in the progression of lung adenocarcinoma.

Citation Format: Byeong Hyeon Choi, Hyonggin An, Sukki Cho, Sungsoo Lee, Hyeong Ryul Kim, Jong Ho Cho, Hyunku Shin, Ok Hwa Jeon, Yeonho Choi, Hyun Koo Kim. GCC2 on small extracellular vesicles for the early diagnosis of lung adenocarcinoma: A multicenter trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB292.