Screening for Cancer

DELTA-P SCREENING FOR LEMS ASSOCIATED WITH SCLC

The DELTA-P (Dutch-English LEMS Tumor Association Prediction) score is a clinical tool developed in 2011 by Titulaer and colleagues—and validated in a 2020 prospective cohort study—that helps predict the risk of cancer in patients with Lambert-Eaton myasthenic syndrome (LEMS).48,51

The abbreviation is also a mnemonic that highlights the signs associated with SCLC-associated LEMS.

D = Difficulty swallowing/neck weakness
E = Erectile dysfunction
L = Loss of weight
T = Tobacco use
A = Age of onset >50 years
P = Performance status on the Karnofsky test*
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Each item is
scored equally51

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Total score ranges from 0-6, with higher scores linked to greater likelihood of small cell lung cancer (SCLC)51

DELTA-P predicts SCLC with

reliability early in the course of LEMS51

*Karnofsky Performance Score is an attempt to quantify cancer patients’ general well-being and their quality of life. The score runs from 100 to 0, where 100 = perfect health and 0 = death. A cutoff value of 70 was chosen; those with values below 70 need at least occasional assistance for activities of daily living.51

Understanding Delta-P Scoring video thumbnail

Mazen Dimachkie, MD, is a leading consultant in the study of LEMS. As the Director of Neuromuscular Research at the University of Kansas Medical Center, he manages one of the busiest neuromuscular clinical trial units in North America.

NeuroseriesLive hosted a webinar featuring Dr. Dimachkie discussing LEMS: “Are My Muscles Aging? One Often-misdiagnosed Cause of Weakness and Fatigue.” Excerpts from this program appear throughout this website, and you can watch the full webinar here.†

†Sponsored by Catalyst Pharmaceuticals.

Screening Steps

A thorough patient history can help uncover key clues

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Review timing of symptom onset in relation to symptom spread or exacerbation

SCLC-associated has a more rapid and aggressive onset than SCLC not associated with LEMS; this can help reveal the signs of an occult tumor52,53

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Verify current or past tobacco use

The majority of cancer-related LEMS cases occur in people with a history of smoking4,13,14,43

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If you suspect cancer

An X-ray, PET scan, or CT scan can reveal tumor presence4,43

Rich’s Patient History

His pursuit of a neuromuscular diagnosis yielded another discovery

Listen as Rich, a 53-year-old with LEMS, recalls the onset of symptoms that led to his eventual diagnosis of LEMS and cancer.

Next: LEMS Expert Webinars >