LUNG CANCER BREATH TESTS

RESEARCH PAPERS

 

According to the US Centers for Disease Control and Prevention (CDC), more people in the United States die from lung cancer than any other type of cancer, for both men and women/ We have  curated selected research papers, articles and web content on the subjects of Lung cancer, screening, diagnosis and treatment.

 

We hope you find this a useful resource.

There are several known methodologies for detection and analysis of volatile organic compounds in human breath.

We believe we have the most accurate and scaleable solution.

 

RESEARCH REPORTS / PAPERS ON TECHNOLOGIES FOR LUNG CANCER BREATH TESTS

Vice President Joe Biden - MoonShot Cancer and early detection
White House Logo

$ 1 BILLION FEDERAL Investments Launch the Next Phase of LUNG Cancer Research

In late January 2016, President Barack Obama announced the establishment of a new Cancer Moonshot Task Force – to be led by Vice President Joe Biden – to focus on making the most of Federal investments, targeted incentives, private sector efforts from industry and philanthropy, patient engagement initiatives, and other mechanisms to support cancer research and enable progress in treatment and care.

 

The Administration is launching the National Cancer Moonshot with a $1 billion initiative to provide the funding necessary for researchers to accelerate the development of new ways to detect and treat cancer, including:

 

The Moonshot initiative will begin immediately with $195 million in new cancer activities at the National Institutes of Health (NIH) in Fiscal Year 2016. The Fiscal Year 2017 Budget will propose to continue this initiative with $755 million in mandatory funds for new cancer-related research activities at both NIH and the Food and Drug Administration.

 

The Departments of Defense and Veterans Affairs are increasing their investments in cancer research, including through funding Centers of Excellence focused on specific cancers, and conducting large longitudinal studies to help determine risk factors and enhance treatment.

 

Within the Department of Health and Human Services (HHS), these investments will support cutting edge research opportunities, such as:

 

Prevention and Cancer Vaccine Development

Cancers caused by viruses can often be prevented by vaccinating people before they become infected, as demonstrated by the vaccine for cervical cancer and other cancers caused by human papillomavirus (HPV). Unique or signature genetic changes in cancers may also be targeted by cancer vaccines. We will speed the development, evaluation, and optimization of safe cancer vaccines targeting unique features of individual cancers.

 

Early Cancer Detection

Recent advances in genomic and proteomic technologies have greatly increased the sensitivity of methods to detect markers of cancer, raising the possibility of using such methods for screening and early detection of cancer. NIH will invest in the development and evaluation of minimally invasive screening assays to enable more sensitive diagnostic tests for cancer.

 

Cancer Immunotherapy and Combination Therapy

This initiative will work to extend the early successes of immunotherapy for cancer treatment to virtually all solid tumors by harnessing the power of the body’s immune system by supporting basic research to increase understanding of how the immune system can be used to modify cancer cells and their activities. In addition, the initiative aims to develop and test new combination therapies. Working with health care providers in the community, as well as through existing clinical trials networks, new approaches to prevent and treat cancer will be tested more quickly and efficiently, with special emphasis made to include under-represented populations. This outreach would also include concerted efforts to narrow cancer health disparity gaps by increasing utilization of standard of care recommendations for cancer prevention, screening, and treatment.

 

Steven Rosenberg, M.D., Ph.D., and former patient Linda Taylor, who was treated with interleukin-2, an immunotherapy developed in Dr. Rosenberg's lab. Taylor has been in complete cancer remission for more than 30 years.

 

Credit: National Cancer Institute

 

Genomic Analysis of Tumor and Surrounding Cells

A greater understanding of cancer genomics—the genetic changes that occur within the cancer cell and in surrounding and immune cells responding to the cancer—will advance both immunotherapy and targeted drug therapy and help lead to an increased ability to enhance patient response to therapy.

 

Enhanced Data Sharing

Data sharing can break down barriers between institutions, including those in the public and private sectors, to enable maximum knowledge gained and patients helped. The cancer initiative will encourage data sharing and support the development of new tools to leverage knowledge about genomic abnormalities, as well as the response to treatment and long-term outcomes.

 

Oncology Center of Excellence

The FDA will develop a virtual Oncology Center of Excellence to leverage the combined skills of regulatory scientists and reviewers with expertise in drugs, biologics, and devices. This center will expedite the development of novel combination products and support an integrated approach in: evaluating products for the prevention, screening, diagnosis, and treatment of cancer supporting the continued development of companion diagnostic tests, and the use of combinations of drugs, biologics and devices to treat cancer developing and promoting the use of methods created through the science of precision medicine

 

Pediatric Cancer

New technology to develop drug libraries and screens for inhibitors against a wide variety of targets will find new therapies, which will be of particular benefit for pediatric populations. The initiative will intensify efforts to collect and analyze tumor specimens from the rarest childhood cancers, enlisting participation from the pediatric oncology community. Clinical data about course of disease and response to therapy will also be included to enable the research community to develop new approaches to treat childhood cancers.

 

Vice President's Exceptional Opportunities in Cancer Research Fund

To launch the National Cancer Moonshot, scientists, cancer physicians, advocates, philanthropic organizations, and representatives of the biotechnology and pharmaceutical industry will need to work together to focus on major new innovations in the understanding of and treatment for cancer. The work that the Vice President will be undertaking will ensure just that—bringing together all parties, breaking down silos, and sharing data to generate new ideas and new breakthroughs. This proposed new fund will be focused on high-risk, high-return research identified by the collaborative work and new ideas stimulated by the research community as part of this work.

 

The National Cancer Moonshot requires a whole-of-government approach, marshalling resources from across the Federal government to address this singular goal. Over time, other agencies will make new investments in this effort, beginning with the Departments of Defense (DOD) and Veterans Affairs (VA).

 

DOD provides tens of millions of dollars annually to support a wide range of cancer research initiatives and continues to increase this work. Most notably, DoD funds three Cancer Centers of Excellence, which focus on Breast, Prostate, and Gynecologic cancers, enabling cutting-edge treatment and research on cancers in our warfighters and other beneficiaries. The world-class Murtha Cancer Treatment Center at the Walter Reed National Military Medical Center, with support from NCI, provides a multidisciplinary approach to offer the highest standards of care for treating cancer diseases. In addition, DOD, through Congressional Special Initiative funding and groundbreaking peer-reviewed research, is investing hundreds of millions of dollars in strengthening the understanding, prevention, detection, and treatment of several of the most prevalent and impactful forms of cancer, as well as less common types of cancer associated with exposure to hazardous materials that some of our service members may encounter while on duty.

 

The VA cancer research portfolio includes close to 250 projects, including 170 clinical studies at VA facilities nationwide. Projects are targeted toward understanding and preventing cancers prevalent in the veteran population, in addition to broader research on veteran populations and disease prevalence. Specific topics being investigated range from the basic biology and genetic underpinning in laboratory-based research to large definitive clinical trials of treatments and approaches to advance care. VA’s Million Veteran Program, with over 445,000 enrolled veterans, 32 percent of whom have reported a cancer diagnosis, provides a potentially rich clinical database for genetic exploration and analyses. This resource will be valuable in investigating genetic contributions to specific cancers and gene targets for potential new treatments. VA’s National Radiation Oncology Program (NROP) is conducting multiple initiatives in cancer research, and its Precision Oncology Program initiative is paving the way for incorporating the results of genetic diagnostic testing to customize medical decision making and treatment for individual patients with cancer.  MORE

NEWS ABOUT BREATH SCREENING TESTS FOR LUNG CANCER

BREATH TEST FOR LUNG CANCER

RAPID, COST EFFECTIVE EARLY DETECTION

A reliable, noninvasive diagnostic method imposes less physical danger while reducing financial burden on patients who have no significant disease. Rapid, effective and most importantly, accurate diagnosis expedites early treatment for patients who have lung cancer.

DANGERS OF FALSE POSITIVE RESULTS

Breath analysis had a much higher specificity than PET (75% vs. 38.7%, respectively) for distinguishing between the presence of lung cancer and other benign diseases. In simple terms, this means that Elemental Breath analysis is not only capable of detecting the precursors to cancer, but also much more accurate in terms of identifying true negatives.

 

This is clearly an important factor for patients, since undergoing a breath analysis rather than a PET scan could ultimately avoid an unnecessary invasive biopsy procedure that might otherwise be required to rule out lung cancer from a less accurate test.

FURTHER ARTICLES AND ABSTRACTS ON EARLY DETECTION OF LUNG CANCER THROUGH BREATH ANALYSIS

Noninvasive Detection of Lung Cancer by Analysis of Exhaled Breath

Open access through BMC-Cancer

http://www.bioxbio.com/if/html/BMC-CANCER.html

 

Abstract

 

Background: Lung cancer is one of the leading causes of death in Europe and the western world. At present, diagnosis of lung cancer very often happens late in the course of the disease since inexpensive, non-invasive and sufficiently sensitive and specific screening methods are not available. Even though the CT diagnostic methods are good, it must be assured that "screening benefit outweighs risk, across all individuals screened, not only those with lung cancer". An early non- invasive diagnosis of lung cancer would improve prognosis and enlarge treatment options. Analysis of exhaled breath would be an ideal diagnostic method, since it is non-invasive and totally painless.

 

Methods: Exhaled breath and inhaled room air samples were analyzed using proton transfer reaction mass spectrometry (PTR-MS) and solid phase microextraction with subsequent gas chromatography mass spectrometry (SPME-GCMS). For the PTR-MS measurements, 220 lung cancer patients and 441 healthy volunteers were recruited. For the GCMS measurements, we collected samples from 65 lung cancer patients and 31 healthy volunteers. Lung cancer patients were in different disease stages and under treatment with different regimes. Mixed expiratory and

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BMC Cancer 2009, 9:348

 http://www.biomedcentral.com/1471-2407/9/348

 

Indoor air samples were collected in Tedlar bags, and either analyzed directly by PTR-MS or transferred to glass vials and analyzed by gas chromatography mass spectrometry (GCMS). Only those measurements of compounds were considered, which showed at least a 15% higher concentration in exhaled breath than in indoor air. Compounds related to smoking behavior such as acetonitrile and benzene were not used to differentiate between lung cancer patients and healthy volunteers.

 

Results: Isoprene, acetone and methanol are compounds appearing in everybody's exhaled breath. These three main compounds of exhaled breath show slightly lower concentrations in lung cancer patients as compared to healthy volunteers (p < 0.01 for isoprene and acetone, p = 0.011 for methanol; PTR-MS measurements). A comparison of the GCMS-results of 65 lung cancer patients with those of 31 healthy volunteers revealed differences in concentration for more than 50 compounds. Sensitivity for detection of lung cancer patients based on presence of (one of) 4 different compounds not arising in exhaled breath of healthy volunteers was 52% with a specificity of 100%. Using 15 (or 21) different compounds for distinction, sensitivity was 71% (80%) with a specificity of 100%. Potential marker compounds are alcohols, aldehydes, ketones and hydrocarbons.

 

Conclusion: GCMS-SPME is a relatively insensitive method. Hence compounds not appearing in exhaled breath of healthy volunteers may be below the limit of detection (LOD). PTR-MS, on the other hand, does not need preconcentration and gives much more reliable quantitative results then GCMS-SPME. The shortcoming of PTR-MS is that it cannot identify compounds with certainty. Hence SPME-GCMS and PTR-MS complement each other, each method having its particular advantages and disadvantages.

 

Exhaled breath analysis is promising to become a future non-invasive lung cancer screening method. In order to proceed towards this goal, precise identification of compounds observed in exhaled breath of lung cancer patients is necessary. Comparison with compounds released from lung cancer cell cultures, and additional information on exhaled breath composition in other cancer forms will be important.

 

Analysis of Exhaled Breath for Disease Detection

Annual Review of Analytical Chemistry

 

Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath res- olution in addition to the conventional central laboratory methods using gas chromatography–mass spectrometry. Breath tests are based on endoge- nously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of ad- verse outcome pathways.

 

 

 

 

 

A review of the volatiles from the healthy human body

Journal of Breath Research

 

A compendium of all the volatile organic compounds (VOCs) emanating from the human body (the volatolome) is for the first time reported. 1840 VOCs have been assigned from breath (872), saliva (359), blood (154), milk (256), skin secretions (532) urine (279), and faeces (381) in apparently healthy individuals. Compounds were assigned CAS registry numbers and named according to a common convention where possible. The compounds have been grouped into tables according to their chemical class or functionality to permit easy comparison. Some clear differences are observed, for instance, a lack of esters in urine with a high number in faeces.

 

Careful use of the database is needed. The numbers may not be a true reflection of the actual VOCs present from each bodily excretion. The lack of a compound could be due to the techniques used or reflect the intensity of effort e.g. there are few publications on VOCs from blood compared to a large number on VOCs in breath. The large number of volatiles reported from skin is partly due to the methodologies used, e.g. collecting excretions on glass beads and then heating to desorb VOCs. All compounds have been included as reported (unless there was a clear discrepancy between name and chemical structure), but there may be some mistaken assignations arising from the original publications, particularly for isomers.

 

It is the authors’ intention that this database will not only be a useful database of VOCs listed in the literature, but will stimulate further study of VOCs from healthy individuals. Establishing a list of volatiles emanating from healthy individuals and increased understanding of VOC metabolic pathways is an important step for differentiating between diseases using VOCs.

 

 

A Study of the Volatile Organic Compounds Exhaled by Lung Cancer Cells In Vitro for Breath Diagnosis

American Cancer Society

 

BACKGROUND: The specific volatile organic compounds (VOCs) exhaled by lung cancer cells in the microenvironment are the source biomarkers of lung cancer and also serve as direct evidence that the diagnosis of lung cancer by breath is possible. However, to the authors’ knowledge, few articles published to date have provided accurate VOCs in the microenvironment, thereby leading to different points of view with regard to searching for biomarkers in the breath from lung cancer patients In this article, an innovative pathologic analysis method of lung cancer and the early diagnosis of lung cancer at the cellular level were intro- duced for this purpose.

 

METHODS: Solid-phase microextraction combined with gas chromatography is used as the detection system to determine the VOCs in the culture medium of several target cells, including different kinds of lung cancer cells, bronchial epithelial cells, tastebud cells, osteogenic cells, and lipocytes. As a result, each kind of cells has a unique chromatogram. There are 4 special VOCs that were found to exist in all culture mediums of lung cancer cells, which are the meta- bolic products of lung cancer cells and can be viewed as markers of lung cancer. RESULTS. The authors were able to determine a correlation between VOCs in the metabolic products of lung cancer cells and VOCs in the breath of lung cancer patients, some of whom had stage I and II disease, and eventually hope to certify the biomarkers in the breath of lung cancer patients.

 

CONCLUSIONS: This research is significant and provides the basis for the noninva- sive detection and the breath diagnosis of lung cancer using an electronic nose. Cancer 2007;110:835–44. ! 2007 American Cancer Society.

 

 

 

Advances in the Early Detection of Lung Cancer using Analysis of Volatile Organic Compounds: From Imaging to Sensors

Asian Pacific Journal of Cancer Prevention

(http://www.bioxbio.com/if/html/ASIAN-PAC-J-CANCER-P.html)

 

According to the World Health Organization (WHO), 1.37 million people died of lung cancer all around the world in 2008, occupying the first place in all cancer-related deaths.

 

However, this number might be decreased if patients were detected earlier and treated appropriately. Unfortunately, traditional imaging techniques are not sufficiently satisfactory for early detection of lung cancer because of limitations. As one alternative, breath volatile organic compounds (VOCs) may reflect the biochemical status of the body and provide clues to some diseases including lung cancer at early stage. Early detection of lung cancer based on breath analysis is becoming more and more valued because it is non-invasive, sensitive, inexpensive and simple. In this review article, we analyze the limitations of traditional imaging techniques in the early detection of lung cancer, illustrate possible mechanisms of the production of VOCs in cancerous cells, present evidence that supports the detection of such disease using breath analysis, and summarize the advances in the study of E-noses based on gas sensitive sensors. In conclusion, the analysis of breath VOCs is a better choice for the early detection of lung cancer compared to imaging techniques.

 

We recommend a more comprehensive technique that integrates the analysis of VOCs and non-VOCs in breath. In addition, VOCs in urine may also be a trend in research on the early detection of lung cancer.

 

 

 

Analysis of volatile organic compounds released from human lung cancer cells and from the urine of tumor-bearing mice

Cancer Cell International IF>2.5 for 2014/2015

http://www.bioxbio.com/if/html/CANCER-CELL-INT.html

 

Background: A potential strategy for the diagnosis of lung cancer is to exploit the distinct metabolic signature of this disease by way of biomarkers found in different sample types. In this study, we investigated whether specific volatile organic compounds (VOCs) could be detected in the culture medium of the lung cancer cell line A549 in addition to the urine of mice implanted with A549 cells.

 

Results: Several VOCs were found at significantly increased or decreased concentrations in the headspace of the A549 cell culture medium as compared with the culture medium of two normal lung cell lines. We also analyzed the urine of mice implanted with A549 cells and several VOCs were also found to be significantly increased or decreased relative to urine obtained from control mice. It was also revealed that seven VOCs were found at increased concentrations in both sample types. These compounds were found to be dimethyl succinate, 2- pentanone, phenol, 2-methylpyrazine, 2-hexanone, 2-butanone and acetophenone.

 

Conclusions: Both sample types produce distinct biomarker profiles, and VOCs have potential to distinguish between true- and false-positive screens for lung cancer.

 

 

 

 

Detection of human metabolites using multi-capillary columns coupled to ion mobility spectrometers

Journal of Chromatography

(http://www.bioxbio.com/if/html/J-CHROMATOGR-A.html)

 

 

The human breath contains indicators of human health and delivers information about different metabolism processes of the body. The detection and attribution of these markers provide the possibility for new, non-invasive diagnostic methods. In the recent study, ion mobility spectrometers are used to detect different volatile organic metabolites in human breath directly. By coupling multi-capillary columns using ion mobility spectrometers detection limits down to the ng/L and pg/L range are achieved.

 

The sampling procedure of human breath as well as the detection of different volatiles in human breath are described in detail. Reduced mobilities and detection limits for different analytes occurring in human breath are reported. In addition, spectra of exhaled air using ion mobility spectrometers obtained without any pre-concentration are presented and discussed in detail. Finally, the potential use of IMS with respect to lung infection diseases will be considered.

 

© 2005 Elsevier B.V. All rights reserved.

 

 

 

 

 

Exhaled Breath Condensate: Technical and Diagnostic Aspects

The Scientific World Journal

 

Purpose: The aim of this study was to evaluate the 30-year progress of research on exhaled breath condensate in a disease-based approach.

 

Methods: We searched PubMed/Medline, ScienceDirect, and Google Scholar using the following keywords: exhaled breath condensate (EBC), biomarkers, pH, asthma, gastroesophageal reflux (GERD), smoking, COPD, lung cancer, NSCLC, mechanical ventilation, cystic fibrosis, pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis, interstitial lung diseases, obstructive sleep apnea (OSA), and drugs. Results. We found 12600 related articles in total in Google Scholar, 1807 in ScienceDirect, and 1081 in PubMed/Medline, published from 1980 to October 2014. 228 original investigation and review articles were eligible. Conclusions. There is rapidly increasing number of innovative articles, covering all the areas of modern respiratory medicine and expanding EBC potential clinical applications to other fields of internal medicine.

 

However, the majority of published papers represent the results of small-scale studies and thus current knowledge must be further evaluated in large cohorts. In regard to the potential clinical use of EBC-analysis, several limitations must be pointed out, including poor reproducibility of biomarkers and absence of large surveys towards determination of reference-normal values. In conclusion, contemporary EBC-analysis is an intriguing achievement, but still in early stage when it comes to its application in clinical practice.

 

 

Noninvasive detection of lung cancer using exhaled breath

Cancer Medicine

 

Early detection of lung cancer is a key factor for increasing the survival rates of lung cancer patients. The analysis of exhaled breath is promising as a non- invasive diagnostic tool for diagnosis of lung cancer.

 

We demonstrate the quantitative analysis of carbonyl volatile organic compounds (VOCs) and iden- tification of lung cancer VOC markers in exhaled breath using unique silicon microreactor technology. The microreactor consists of thousands of micropillars coated with an ammonium aminooxy salt for capture of carbonyl VOCs in exhaled breath by means of oximation reactions. Captured aminooxy-VOC adducts are analyzed by nanoelectrospray Fourier transform-ion cyclotron reso- nance (FT-ICR) mass spectrometry (MS). The concentrations of 2-butanone, 2-hydroxyacetaldehyde, 3-hydroxy-2-butanone, and 4-hydroxyhexenal (4-HHE) in the exhaled breath of lung cancer patients (n = 97) were significantly higher than in the exhaled breath of healthy smoker and nonsmoker controls (n = 88) and patients with benign pulmonary nodules (n = 32). The concentration of 2-butanone in exhaled breath of patients (n = 51) with stages II though IV non–small cell lung cancer (NSCLC) was significantly higher than in exhaled breath of patients with stage I (n = 34). The carbonyl VOC profile in exhaled breath determined using this new silicon microreactor technology provides for the noninvasive detection of lung cancer.

 

 

 

Hereditary lung cancer syndrome targets never smokers with germline EGFR gene T790M mutations

http://www.jto.org/article/S1556-0864%2815%2930240-9/fulltext

 

Introduction:

Hereditary lung cancer syndromes are rare, and T790M germline mutations of the epidermal growth factor receptor (EGFR) gene predispose to the development of lung cancer. The goal of this study was to determine the clinical features and smoking status of lung cancer cases and unaffected family members with this germline mutation and to estimate its incidence and penetrance.

 

Methods:

We studied a family with germline T790M mutations over five generations (14 individuals) and combined our observations with data obtained from a literature search (15 individuals).

 

Results:

T790M germline mutations occurred in approximately 1% of non–small-cell lung cancer cases and in less than one in 7500 subjects without lung cancer. Both sporadic and germline T790M mutations were predominantly adenocarcinomas, favored female gender, and were occasionally multifocal. Of lung cancer tumors arising in T790M germline mutation carriers, 73% contained a second activating EGFR gene mutation. Inheritance was dominant. The odds ratio that T790M germline carriers who are smokers will develop lung cancer compared with never smoker carriers was 0.31 (p = 6.0E-05). There was an overrepresentation of never smokers with lung cancer with this mutation compared with the general lung cancer population (p = 7.4E-06).

Conclusion:

Germline T790M mutations result in a unique hereditary lung cancer syndrome that targets never smokers, with a preliminary estimate of 31% risk for lung cancer in never smoker carriers, and this risk may be lower for heavy smokers. The resultant cancers share several features and differences with lung cancers containing sporadic EGFR mutations.

 

 

 

 

 

 

Non-Invasive Breath Analysis of Pulmonary Nodules

J Thorac Oncol

 

INTRODUCTION: The search for non-invasive diagnostic methods of lung cancer has led to new avenues of research, including the exploration of the exhaled breath. Previous studies have shown that lung cancer can in principle be detected through exhaled breath analysis. This study evaluated the potential of exhaled breath analysis for the distinction of benign and malignant pulmonary nodules (PNs).

 

METHODS: Breath samples were taken from 72 patients with PNs in a prospective trial. Profiles of volatile organic compounds (VOCs) were determined by (i) gas chromatography/mass spectrometry (GC-MS) combined with solid phase microextraction (SPME) and by (ii) a chemical nanoarray.

 

RESULTS:  53 PNs were malignant and 19 were benign with similar smoking histories and co- morbidities. Nodule size (mean +/− SD) was 2.7±1.7 vs. 1.6±1.3 cm (p=0.004) respectively. Within the malignant group, 47 were NSCLC and 6 were SCLC. Thirty had early stage disease and 23 had advanced disease. GC-MS analysis identified a significantly higher concentration of 1- octene in the breath of lung cancer, and the nanoarray distinguished significantly between benign vs. malignant PNs (p<0.0001; accuracy 88±3%), between adeno- and squamous- cell carcinomas (p<0.0001; 88±3%) and between early stage and advanced disease (p<0.0001; 88±2%).

 

CONCLUSIONS: In this pilot study, breath analysis discriminated benign from malignant PNs in a high-risk cohort based on lung cancer related VOC profiles. Further, it discriminated adeno- and squamous- cell carcinoma and between early vs. advanced disease. Further studies are required to validate this non-invasive approach, using a larger cohort of patients with PNs detected by CT.

 

 

 

Quantitative breath analysis of volatile organic compounds of lung cancer patients

http://www.ncbi.nlm.nih.gov/pubmed/19409642

Lung Cancer

 

Due to state-of-art analytical techniques, non-invasive exhaled volatile organic compounds (VOCs) anal- ysis has become a potential method for early diagnosis of lung cancer. We collected breath samples from 43 patients with non-small cell lung cancer (NSCLC) and 41 normal controls using Tedlar® gas bags. The VOCs were extracted with solid phase micro-extraction (SPME) and analyzed by gas chromatography (GC)/mass spectrometry (MS). The number of VOCs detected in each breath sample ranged from 68 to 114. Among the VOCs 1-butanol and 3-hydroxy-2-butanone were found at significantly higher concentrations in breath of the lung cancer patients compared to the controls.

 

VOCs levels were not significantly differ- ent between early stage lung cancer patients and late stage lung cancer patients. Lung adenocarcinoma was significantly related to higher VOCs concentrations in the breath. Our data showed that 1-butanol and 3-hydroxy-2-butanone in breath could possibly be taken as useful breath biomarkers for discerning potential lung cancer patients and VOCs analysis could be used as a complementary test for the diagnosis of lung cancer.

 

 

 

The scent of human diseases: a review on specific volatile organic compounds as diagnostic biomarkers

http://www.ncbi.nlm.nih.gov/pubmed/21771869

Flavor & Fragrance Journal

 

The use of body odours, emitted in the form of volatile organic compounds (VOCs), has become the focus of scientific research in recent years.

Diseases such as cancer, metabolic disorders, infections and some other diseases can change the components of daily VOCs, often leading to the production of disease-specific VOCs that might be used as diagnostic biomarkers if detected early enough. We summarize here scientific publications (2003–2013) related to the study of VOCs in human diseases.

 

 

 

 

Volatile Organic Compounds of Lung Cancer and Possible Biochemical Pathways

Chemical Reviews

Open Access

 

Exhaled volatile organic compounds as lung cancer biomarkers during one-lung ventilation

 

Scientific Reports

In this study, single-lung ventilation was used to detect differences in the volatile organic compound (VOCs) profiles between lung tissues in healthy and affected lungs. In addition, changes that occurred after lung cancer resection in both the VOCs profiles of exhaled breath from ipsilateral and contralateral lungs and the VOCs profiles of exhaled breath and blood sample headspaces were also determined. Eighteen patients with non-small cell carcinoma were enrolled. Alveolar breath samples were taken separately from healthy and diseased lungs before and after the tumor resection. Solid phase microextraction–gas chromatography/mass spectrometry was used to assess the exhaled VOCs of the study participants.

 

The VOCs exhibited significant differences between the contralateral and ipsilateral lungs before surgery, the contralateral and ipsilateral lungs after surgery, the ipsilateral lungs before and after surgery, and the blood samples from before and after surgery; 12, 19, 12 and 5 characteristic metabolites played decisive roles in sample classification, respectively. 2,2-Dimethyldecane, tetradecane, 2,2,4,6,6-pentamethylheptane, 2,3,4-trimethyldecane, nonane, 3,4,5,6-tetramethyloctane, and hexadecane may be generated from lipid peroxidation during surgery. Caprolactam and propanoic acid may be more promising exhaled breath biomarkers for lung cancer.

 

 

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REFERENCES:

Sources: American Lung Association and CDC 2011 data

Nature (2015), Analytical Chemistry (2014), Cancer Medicine (2013), Cancer Cell (2012), American Chemical Society (2012), Nanomedicine (2012), Bristish Jounal of Medicine (2010), British Journal of Cancer (2010), BioMed Central (2009), Clinica Chimica Acta (2009), American Cancer Society (2007), Journal of Chromatography (2005)

 

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