Exhaled Breath Analysis for Monitoring Response to Treatment in Advanced Lung Cancer

TL;DR

This study explores breath analysis as a rapid, non-invasive method to monitor treatment response in advanced lung cancer, potentially offering earlier detection of therapy failure than traditional imaging.

Contribution

It introduces a novel breath sampling approach using gas chromatography and nanomaterial sensors to assess treatment response, providing a quicker bedside alternative to RECIST criteria.

Findings

Gas chromatography identified three volatile compounds linked to disease control.

Nanoarray sensors monitored tumor response changes effectively.

59% accuracy with single sensors in follow-up samples.

Abstract

INTRODUCTION: The Response Evaluation Criteria in Solid Tumors (RECIST) serve as the accepted standard to monitor treatment efficacy in lung cancer. However, the time intervals between consecutive computerized tomography scans might be too long to allow early identification of treatment failure. This study examines the use of breath sampling to monitor responses to anticancer treatments in patients with advanced lung cancer. METHODS: A total of 143 breath samples were collected from 39 patients with advanced lung cancer. The exhaled breath signature, determined by gas chromatography/mass spectrometry and a nanomaterial-based array of sensors, was correlated with the response to therapy assessed by RECIST: complete response, partial response, stable disease, or progressive disease. RESULTS: Gas chromatography/mass spectrometry analysis identified three volatile organic compounds as significantly indicating disease control (PR/stable disease), with one of them also significantly discriminating PR/stable disease from progressive disease. The nanoarray had the ability to monitor changes in tumor response across therapy, also indicating any lack of further response to therapy. When one-sensor analysis was used, 59% of the follow-up samples were identified correctly. There was 85% success in monitoring disease control (stable disease/partial response). CONCLUSION: Breath analysis, using mainly the nanoarray, may serve as a surrogate marker for the response to systemic therapy in lung cancer. As a monitoring tool, it can provide the oncologist with a quick bedside method of identifying a lack of response to an anticancer treatment. This may allow quicker recognition than does the current RECIST analysis. Early recognition of treatment failure could improve patient care.