Researchers are evaluating whether a breath test can detect malignant pleural mesothelioma in patients with asbestos exposure, and early results suggest it may be possible, but more research is needed.

The test, which detects volatile organic compounds in exhaled breath, is being evaluated in the MESOBREATH 5 study.

Early results showed that the test has high sensitivity and negative predictive value but low accuracy, specificity, and positive predictive value. These results were presented at the 2023 World Conference on Lung Cancer.

Patients included in this study were required to have a history of substantial occupational asbestos exposure, with a first exposure occurring at least 30 years ago and having at least 15 fiber years. The researchers also included a positive control group of patients with confirmed pleural mesothelioma. 

The cohort included 121 patients with a history of asbestos exposure and 7 patients with confirmed mesothelioma. All patients in the asbestos-exposed group were men, as were 71% of patients in the mesothelioma group (P =.020). Patients in the asbestos-exposed group had a higher mean body mass index (27.42 kg/m2 vs 24.23 kg/m2; P =.042) and were younger (mean, 60.61 years vs 69.59 years; P =.002).

All patients underwent breath testing in 2022 and this year. The sensitivity and negative predictive value of the breath test were both 100%. However, the positive predictive value was 4.2%, the accuracy was 29.1%, and the specificity was 26.9%.

To reduce false positives, the researchers decided to test patients twice and look at patients with positive results from both tests. About 46% of patients had 2 positive test results, including all 7 patients with confirmed mesothelioma.

The next step in this study is for patients with 2 positive results to undergo low-dose CT scans to confirm whether they have mesothelioma or if other factors could have influenced their breath test results. The researchers plan to use this information to optimize the test further.

The researchers also plan to continue giving patients the breath test in 2024 and 2025, and this will be followed by CT scans to confirm the presence or absence of mesothelioma.

Disclosures: No disclosures were provided.


Lamote K, Zwijsen K, Schillebeeckx E, et al. Determining the clinical utility of a breath test to screen asbestos-exposed persons for pleural mesothelioma. Presented at WCLC 2023. September 9-12, 2023. Abstract MA17.03.