KUALA LUMPUR, March 21 — Lung Cancer Network Malaysia (LCNM) has introduced an artificial intelligence (AI)-enhanced liquid biopsy using circulating tumour DNA (ctDNA) analysis, a move that could improve lung cancer screening and early detection, the organisation said on Thursday.
The molecular DNA liquid biopsy, which employs next-generation sequencing and multi-modal AI, detects ctDNA from a 10ml blood sample. Circulating tumour DNA (ctDNA) refers to fragments of tumour-derived DNA found in the bloodstream.
With reported sensitivity and specificity exceeding 90 per cent, the technology may complement existing imaging methods and refine screening strategies, LCNM said.
Lung cancer remains a major health burden in Asia, accounting for more than 60 per cent of global cases and deaths annually.
In Malaysia, the disease is the second most prevalent cancer among men and the third among women, according to the Malaysian National Cancer Registry (2017-2021). It remains the leading cause of cancer-related deaths in men, while only breast cancer causes more deaths among women.
“The dismal prognosis is largely driven by late-stage diagnosis in almost 95 per cent of cases,” said Prof Dr Anand Sachithanandan, a cardiothoracic surgeon and LCNM founding president. “With targeted screenings, we can create meaningful stage shifts to detect more cases at an early stage when the disease is amenable to curative therapy.”
The Ministry of Health (MOH) has proposed a national Lung Health Initiative (LHI) to improve early detection, a move that LCNM supports. However, Dr Anand stressed the need for careful execution to ensure long-term impact.
Since 2019, LCNM has led efforts to improve lung cancer screening, initially through low-dose CT (LDCT) imaging and more recently through AI-enabled chest radiography to identify high-risk individuals. The organisation’s experience suggests that people are more willing to undergo chest X-rays than LDCT scans as an initial screening step.
However, Dr Anand emphasised that LDCT remains the gold standard.
“Screening initiatives must be targeted towards ‘at risk’ groups to be cost-effective and truly beneficial and should involve relevant organisations like LCNM who have the necessary expertise and experience,” he said. “Screening, after all, is a process and not an isolated investigation. Managing the equivocal or indeterminate scan and associated anxiety requires thoughtful consideration and specialist knowledge.”
Beyond early detection, reducing the time from diagnosis to treatment is critical for survival, he added.
“Waiting times for operation theatre slots for definitive curative surgery or how quickly a patient can access pre-operative neoadjuvant chemo-immunotherapy, if indicated, are important real-world factors.
“For timely diagnosis and intervention, adequate resources, close collaboration between government hospitals and high-volume one-stop private centres of excellence, and a well-defined patient care pathway are requisite to ensure a swift and seamless patient journey,” Dr Anand said.
LCNM’s recent introduction of AI-enhanced liquid biopsy is particularly beneficial for individuals with abnormal chest X-ray findings. The technology analyses a 10ml blood sample to detect molecular markers of lung cancer, differentiating tumour-derived ctDNA from healthy DNA.
“The technology has immense potential to refine and augment existing screening, including addressing the unmet need to diagnose lung cancer earlier in high-risk non-smokers, a cohort neglected by traditional screening criteria,” Dr Anand said.
“This is of particular importance given the increasing number of lung cancer cases occurring in never-smokers, predominantly women, globally, including here in Malaysia. A family history of lung cancer seems highly pertinent for this group.”
With rising health care costs, early screening could also ease the financial burden of treating late-stage lung cancer, which is more expensive and often non-curative, he said.
LCNM is confident the MOH has conducted the necessary workforce and infrastructure planning and secured appropriate funding for large-scale screenings.
