Researchers from Israel, the United States, and the United Kingdom have found that a breathalyzer test embedded with a nanotech chip can “sniff out” lung cancers from a simple breath sample, allowing for rapid and early diagnosis of lung cancer.
The study, which included 358 patients, found that the breathalyzer test could detect lung cancer with 90% accuracy even when the lung nodule was tiny and difficult to sample. Other subtypes of cancer could also be discriminated, which was an unexpected find. The results of this study, which were presented at the 2014 Annual Meeting of the American Society of Clinical Oncology (ASCO)1 demonstrated that lung cancer tumors produce volatile organic compounds (VOCs) that evaporate into the air and produce a discernible scent profile.
“The breath analysis is a lot easier than drawing blood or urine testing,” said study investigator Paul Bunn, MD, professor of medicine in Medical Oncology at the University of Colorado Health Sciences Center, in Denver, CO.
This study included 213 patients with lung cancer (62 with early disease and 143 with advanced disease). The patients with lung cancer were matched with chronic obstructive pulmonary disease (COPD) controls. The researchers reported that the breath test could distinguish between controls and patients with early lung cancer with 85.11% accuracy, controls and advanced lung cancer with 82.11% accuracy, and early and advanced disease with 78.75% accuracy.
“Not in the next 2 years, but hopefully within 5 years, this could be part of routine practice,” Dr. Bunn said in an interview with ChemotherapyAdvisor.com. “We would like to better define risk. What we are doing at the moment is we are seeing which nodules have to be resected, and which patients can be watched.”
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Better defining which patients with lung cancer may be most appropriate for active surveillance could significantly lower morbidity and mortality. Statistics on lung cancer survival vary depending on the stage of the cancer at the time of diagnosis. The American Cancer Society estimates that there will be 159,260 deaths from lung cancer in 2014, accounting for about 27% of all cancer deaths this year in the United States alone.2 The 5-year survival rate estimates are 49% for patients with stage IA non-small cell lung cancer, 30% for stage IIA, 14% for stage IIIA and 1% for stage IV.
Dr. Bunn envisions breath analyses as a rapid and early diagnostic tool for monitoring disease recurrence after resection. The breathalyzer test was developed by Professor Nir Peled of Tel Aviv University in Israel, who said lung cancer cells have a unique signature and the larger the tumor, the more robust the signature.
“On top of early detection, we also performed a study showing that the volatile signature can predict the response of therapy, such as monitoring the necrosis process. Therefore, we may detect lack of response very early, even before the imaging system shows that,” Dr. Peled told ChemotherapyAdvisor.com.
Mark Deffebach, MD, associate professor of Pulmonary & Critical Care Medicine, at Oregon Health & Science University, in Portland, OR, said the study findings are intriguing; however, instead of using COPD patients as controls, he would like to see how well this test performs in patients who simply have an imaging abnormality.
In addition, Dr. Deffebach said that the accuracy rates also would need to be improved before this test could be used in the clinic in its current form. “It only picked up about 80% of cancers. That sounds good, but if you say it missed 20%, then that doesn’t sound so good.”
- Peled N, Abud-Hawa M, Liran O, et al. Breath analysis as a noninvasive biomarker for early detection of lung cancer. J Clin Oncol. 2014;32(suppl): Abstract 7560.
- American Cancer Society. What are the key statistics about lung cancer? http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-key-statistics. Accessed June 26, 2014.