Smoking, being age 50 or older, and significant weight loss within three months of LEMS onset all predict the development of SCLC.
The research, “Lung cancer prediction in Lambert-Eaton myasthenic syndrome in a prospective cohort,” was published in the journal Scientific Reports.
LEMS affects the neuromuscular junction — the place where motor nerve cells and muscle fibers communicate — leading to muscle weakness, reduced reflexes, and extreme fatigue.
The rare autoimmune disorder is often associated with cancer, in particular SCLC, which is responsible for nearly 60% of all cases of LEMS.
To better understand a LEMS patient’s risks of SCLC, a team from the Netherlands and the U.K. had previously developed and validated a cancer prediction scoring tool. It enabled the differentiation between SCLC-LEMS and LEMS not associated with cancer.
Now, the same researchers sought to further validate their cancer prediction tool, called the Dutch-English LEMS Tumour Association Prediction (DELTA-P) score. The tool was tested among a second group of patients newly diagnosed with LEMS to assess the DELTA-P’s utility in a real-world setting.
The study included 87 people with LEMS — 54 women and 33 men. Clinical data collected within three months following the onset of LEMS was used to calculate the individual DELTA-P score.
A total of 44 patients (51%) had SCLC associated with LEMS, while the remaining 43 (49%) had no underlying tumor.
Notably, the median age at LEMS diagnosis was 65 in patients with SCLC and 58 in participants without cancer. In addition, the group with SCLC had a greater proportion of participants ages 50 or older (91% vs. 70%), of smokers (66% vs. 16%), and of participants who lost at least 5% of their body weight within three months of LEMS onset (61% vs. 19%).
After comparing DELTA-P scores between the two groups, the investigators found that the median scores were significantly higher among participants with SCLC-LEMS compared with those without cancer (3.5 vs. 2).
Higher DELTA-P scores were associated with an increased risk of SCLC. Patients with DELTA-P scores ranging from 0 to 1 had a low risk of having SCLC (0-18.8%), while those with scores ranging from 4 to 6 were at a high risk of having lung cancer (85.7-100%)
Statistical analyses also identified being age 50 or older at LEMS onset, smoking, and weight loss of at least 5% as independent predictors for the development of SCLC among people with LEMS.
Overall, the DELTA-P score, calculated at the time of LEMS diagnosis, is an effective way to screen for cancer, the scientists said.
“Using clinically validated data from a large prospective cohort, we have confirmed that the use of the DELTA-P scoring system at LEMS diagnosis is a robust measure of the risk of developing SCLC,” they wrote.
“Confirmation of the validity of the DELTA-P scoring system by other international investigators would be of great clinical value,” the team added.
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