PREVALUNG EU: Better Assessing Lung Cancer Risk to Tailor Prevention Strategies

Smoking increases the risk of both cardiovascular disease and lung cancer. PREVALUNG EU is based on the hypothesis that certain abnormalities observed in the body may help us better understand the link between cardiovascular risk factors and an increased risk of lung cancer.

Currently, lung cancer screening for at-risk individuals relies primarily on low-dose chest CT scans. PREVALUNG EU is not intended to replace this test. The project aims to determine whether biomarkers can help better identify and monitor at-risk individuals, and subsequently offer more personalized preventive measures.

A biomarker is a measurable biological characteristic—for example, in blood or in samples used to study the microbiome—that can provide information about how the body functions, a risk factor, or the progression of a disease. Exploratory analyses conducted in the PREVALUNG study identified four major sets of markers, which PREVALUNG EU must now refine and validate in other European populations.

• Autophagy and Metabolism

  Autophagy plays a role in the recycling of cellular components. Dysregulation of autophagy, combined with changes in metabolism, may contribute to a environment conducive to carcinogenesis.

• Innate Immunity

  This first line of defense in the body is involved in the response to threats and in inflammation. The project is studying certain immune signals associated with risk.

• Intestinal Barrier and Microbiota

  An imbalance in the gut microbiota and an impairment of the intestinal barrier can sustain systemic inflammation. PREVALUNG EU is analyzing their association with lung cancer risk.

• Clonal hematopoiesis

  With age, certain bone marrow stem cells can acquire mutations and form blood clones. This phenomenon is associated with cardiovascular diseases and certain cancers, though it does not necessarily mean that cancer is present.

PREVALUNG EU is an extension of the prospective PREVALUNG study, launched in 2019 at Marie Lannelongue Hospital, part of the Paris Saint Joseph Hospital Group, in collaboration with the teams led by Prof. David Boulate and Prof. Laurence Zitvogel. This initial study included 508 smokers or former smokers aged 45 to 75 with a history of tobacco-related cardiovascular disease.

Among these asymptomatic participants, a screening protocol that included a low-dose chest CT scan estimated the prevalence of lung cancer in the study population to be approximately 3%. Exploratory analyses then focused on metabolism, the microbiome, blood proteins, immunity, and clonal hematopoiesis. These results have yet to be confirmed in the larger cohorts of the European program.

A European, Multidisciplinary Research Effort

The consortium brings together specialists in oncology, cardiology, pulmonology, thoracic surgery, epidemiology, immunology, metabolism, and biomarker development. Technology partners are also contributing to the development of analytical methods, while patient involvement is intended to help design tools tailored to their needs.

Consortium Partners

European Funding

PREVALUNG EU is funded under the Horizon Europe program. Grant Agreement No. 101095604 provides for a contribution from the European Union of 7,016,124 euros. The project began on December 1, 2022, and is scheduled to end on November 30, 2027.