Aptamer-Based Screening and Detection of Serum Biomarkers for Lung Cancer

Lung cancer remains the leading cause of cancer death worldwide, and most patients are still diagnosed after symptoms appear, when curative treatment is no longer possible. Low-dose computed tomography (LDCT) reduces mortality in high-risk smokers, yet uptake is low, eligibility criteria exclude the large never-smoker populations of East Asia, and false-positive findings generate downstream harm. A blood test that could triage who needs imaging, or rule out disease in indeterminate nodules, would therefore have substantial clinical value. Aptamers - short single-stranded oligonucleotides selected in vitro and produced by chemical synthesis - are attractive as the recognition layer of such a test because they can be generated against native membrane proteins and glycans, are thermostable and can be labelled site-specifically at low cost. Here we review the serum biomarker landscape in lung cancer, the chemistry that makes aptamers usable in serum, the selection strategies that now deliver picomolar binders within days, and the transduction architectures that convert binding into a clinical readout. We argue that analytical sensitivity is no longer the limiting factor: the field’s bottleneck has moved upstream to matrix-adapted affinity and downstream to prospective, blinded validation.