1
|
Zwijsen K, Schillebeeckx E, Janssens E, Cleemput JV, Richart T, Surmont VF, Nackaerts K, Marcq E, van Meerbeeck JP, Lamote K. Determining the clinical utility of a breath test for screening an asbestos-exposed population for pleural mesothelioma: baseline results. J Breath Res 2023; 17:047105. [PMID: 37683624 DOI: 10.1088/1752-7163/acf7e3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 09/08/2023] [Indexed: 09/10/2023]
Abstract
Pleural mesothelioma (PM) is an aggressive cancer of the serosal lining of the thoracic cavity, predominantly caused by asbestos exposure. Due to nonspecific symptoms, PM is characterized by an advanced-stage diagnosis, resulting in a dismal prognosis. However, early diagnosis improves patient outcome. Currently, no diagnostic biomarkers or screening tools are available. Therefore, exhaled breath was explored as this can easily be obtained and contains volatile organic compounds, which are considered biomarkers for multiple (patho)physiological processes. A breath test, which differentiates asbestos-exposed (AEx) individuals from PM patients with 87% accuracy, was developed. However, before being implemented as a screening tool, the clinical utility of the test must be determined. Occupational AEx individuals underwent annual breath tests using multicapillary column/ion mobility spectrometry. A baseline breath test was taken and their individual risk of PM was estimated. PM patients were included as controls. In total, 112 AEx individuals and six PM patients were included in the first of four screening rounds. All six PM patients were correctly classified as having mesothelioma (100% sensitivity) and out of 112 AEx individuals 78 were classified by the breath-based model as PM patients (30% specificity). Given the large false positive outcome, the breath test will be repeated annually for three more consecutive years to adhere to the 'test, re-test' principle and improve the false positivity rate. A low-dose computed tomography scan in those with two consecutive positive tests will correlate test positives with radiological findings and the possible growth of a pleural tumor. Finally, the evaluation of the clinical value of a breath-based prediction model may lead to the initiation of a screening program for early detection of PM in Aex individuals, which is currently lacking. This clinical study received approval from the Antwerp University Hospital Ethics Committee (B300201837007).
Collapse
Affiliation(s)
- Kathleen Zwijsen
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium
| | - Eline Schillebeeckx
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium
- VIB-UGent Center for Medical Biotechnology, 9000 Ghent, Belgium
| | - Eline Janssens
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium
| | - Joris Van Cleemput
- Occupational Health Service, Eternit N.V., 1880 Kapelle-op-den-Bos, Belgium
| | | | - Veerle F Surmont
- Department of Respiratory Medicine, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium
| | - Kristiaan Nackaerts
- Department of Respiratory Medicine, University Hospital Gasthuisberg, 3000 Leuven, Belgium
| | - Elly Marcq
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, 2610 Antwerp, Belgium
| | - Jan P van Meerbeeck
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium
- Department of Pulmonology & Thoracic Oncology, Antwerp University Hospital, 2650 Edegem, Belgium
| | - Kevin Lamote
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium
| |
Collapse
|
2
|
Kiss H, Örlős Z, Gellért Á, Megyesfalvi Z, Mikáczó A, Sárközi A, Vaskó A, Miklós Z, Horváth I. Exhaled Biomarkers for Point-of-Care Diagnosis: Recent Advances and New Challenges in Breathomics. MICROMACHINES 2023; 14:391. [PMID: 36838091 PMCID: PMC9964519 DOI: 10.3390/mi14020391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/29/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Cancers, chronic diseases and respiratory infections are major causes of mortality and present diagnostic and therapeutic challenges for health care. There is an unmet medical need for non-invasive, easy-to-use biomarkers for the early diagnosis, phenotyping, predicting and monitoring of the therapeutic responses of these disorders. Exhaled breath sampling is an attractive choice that has gained attention in recent years. Exhaled nitric oxide measurement used as a predictive biomarker of the response to anti-eosinophil therapy in severe asthma has paved the way for other exhaled breath biomarkers. Advances in laser and nanosensor technologies and spectrometry together with widespread use of algorithms and artificial intelligence have facilitated research on volatile organic compounds and artificial olfaction systems to develop new exhaled biomarkers. We aim to provide an overview of the recent advances in and challenges of exhaled biomarker measurements with an emphasis on the applicability of their measurement as a non-invasive, point-of-care diagnostic and monitoring tool.
Collapse
Affiliation(s)
- Helga Kiss
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Zoltán Örlős
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Áron Gellért
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Zsolt Megyesfalvi
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Angéla Mikáczó
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| | - Anna Sárközi
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| | - Attila Vaskó
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| | - Zsuzsanna Miklós
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Ildikó Horváth
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| |
Collapse
|
3
|
Gashimova EM, Temerdashev AZ, Porkhanov VA, Polyakov IS, Perunov DV. Comparative Analysis of Pre- and Post-Surgery Exhaled Breath Profiles of Volatile Organic Compounds of Patients with Lung Cancer and Benign Tumors. JOURNAL OF ANALYTICAL CHEMISTRY 2022. [DOI: 10.1134/s1061934822120036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
4
|
Van Malderen K, Hanning N, Lambrechts H, Haverhals T, Van Marcke S, Ceuleers H, De Man JG, De Winter BY, Lamote K, De Schepper HU. Volatile organic compound profiling as a potential biomarker in irritable bowel syndrome: A feasibility study. Front Med (Lausanne) 2022; 9:960000. [PMID: 35991639 PMCID: PMC9388331 DOI: 10.3389/fmed.2022.960000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
Background Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder for which no diagnostic tools are currently available. Patients are diagnosed using the Rome IV criteria and subtyped into a diarrhea, constipation, or mixed phenotype based on their dominant stool pattern. A recent development in the biomarker area is the analysis of volatile organic compounds (VOCs). The aim of this study was to evaluate the potential of VOCs as diagnostic and phenotypic biomarkers for IBS in breath and fecal samples. Materials and methods Breath and fecal samples from IBS patients and healthy asymptomatic controls (HC) were analyzed with multicapillary column/ion mobility spectrometry (MCC/IMS) and classification models were created based upon VOCs and clinical characteristics. Discussion Irritable bowel syndrome patients were differentiated from HC by means of volatile profiling in both breath and fecal samples with area under the curve (AUCs) of respectively 0.62 and 0.80. Patient subtypes could also be differentiated from each other with AUCs ranging between 0.65 and 0.78. Furthermore, VOC models could differentiate IBS patients based on clinical characteristics like psychological comorbidities and microbiota-influencing therapies. Conclusion This study is the first to demonstrate the use of VOC profiling with the help of MCC/IMS to differentiate IBS patients. Furthermore, the importance of clinical characteristics beside the dominant stool pattern in the differentiation of IBS patients was emphasized.
Collapse
Affiliation(s)
- Kathleen Van Malderen
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium
| | - Nikita Hanning
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Helen Lambrechts
- Medical School, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Tine Haverhals
- Medical School, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Silke Van Marcke
- Medical School, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Hannah Ceuleers
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Joris G. De Man
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Benedicte Y. De Winter
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium
| | - Kevin Lamote
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Heiko U. De Schepper
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium
- *Correspondence: Heiko U. De Schepper,
| |
Collapse
|
5
|
Gashimova EM, Temerdashev AZ, Porkhanov VA, Polyakov IS, Perunov DV. Volatile Organic Compounds in Exhaled Breath as Biomarkers of Lung Cancer: Advances and Potential Problems. JOURNAL OF ANALYTICAL CHEMISTRY 2022. [DOI: 10.1134/s106193482207005x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
6
|
Janssens E, Schillebeeckx E, Zwijsen K, Raskin J, Van Cleemput J, Surmont VF, Nackaerts K, Marcq E, van Meerbeeck JP, Lamote K. External Validation of a Breath-Based Prediction Model for Malignant Pleural Mesothelioma. Cancers (Basel) 2022; 14:cancers14133182. [PMID: 35804954 PMCID: PMC9264774 DOI: 10.3390/cancers14133182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Malignant pleural mesothelioma (MPM) is an incurable asbestos-related thoracic cancer for which early-stage diagnosis remains a major challenge. Volatile organic compounds (VOCs), which are metabolites present in exhaled breath, have proven to be promising non-invasive biomarkers for MPM. However, without the necessary validation in an independent group of individuals, clinical implementation is hampered. Therefore, we performed external validation of a VOC-based prediction model for MPM, which initially revealed a poor performance and thus poor generalisability of the model. However, subsequent updating of the model improved its performance in the validation cohort, resulting in a more generalisable model with a screening potential, which could significantly impact MPM management. Abstract During the past decade, volatile organic compounds (VOCs) in exhaled breath have emerged as promising biomarkers for malignant pleural mesothelioma (MPM). However, as these biomarkers lack external validation, no breath test for MPM has been implemented in clinical practice. To address this issue, we performed the first external validation of a VOC-based prediction model for MPM. The external validation cohort was prospectively recruited, consisting of 47 MPM patients and 76 asbestos-exposed (AEx) controls. The predictive performance of the previously developed model was assessed by determining the degree of agreement between the predicted and actual outcome of the participants (patient/control). Additionally, to optimise the performance, the model was updated by refitting it to the validation cohort. External validation revealed a poor performance of the original model as the accuracy was estimated at only 41%, indicating poor generalisability. However, subsequent updating of the model improved the differentiation between MPM patients and AEx controls significantly (73% accuracy, 92% sensitivity, and 92% negative predictive value), substantiating the validity of the original predictors. This updated model will be more generalisable to the target population and exhibits key characteristics of a potential screening test for MPM, which could significantly impact MPM management.
Collapse
Affiliation(s)
- Eline Janssens
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium; (E.J.); (E.S.); (K.Z.); (J.P.v.M.)
| | - Eline Schillebeeckx
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium; (E.J.); (E.S.); (K.Z.); (J.P.v.M.)
- VIB-UGent Center for Medical Biotechnology, 9000 Ghent, Belgium
| | - Kathleen Zwijsen
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium; (E.J.); (E.S.); (K.Z.); (J.P.v.M.)
| | - Jo Raskin
- Department of Pulmonology & Thoracic Oncology, Antwerp University Hospital, 2650 Edegem, Belgium;
| | - Joris Van Cleemput
- Occupational Health Service, Eternit N.V., 1880 Kapelle-op-den-Bos, Belgium;
| | - Veerle F. Surmont
- Department of Respiratory Medicine, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Kristiaan Nackaerts
- Department of Respiratory Medicine, University Hospital Gasthuisberg, 3000 Leuven, Belgium;
| | - Elly Marcq
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, 2610 Antwerp, Belgium;
| | - Jan P. van Meerbeeck
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium; (E.J.); (E.S.); (K.Z.); (J.P.v.M.)
- Department of Pulmonology & Thoracic Oncology, Antwerp University Hospital, 2650 Edegem, Belgium;
- Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium
| | - Kevin Lamote
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Center of Excellence, University of Antwerp, 2610 Antwerp, Belgium; (E.J.); (E.S.); (K.Z.); (J.P.v.M.)
- Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium
- Correspondence: ; Tel.: +32-3-265-25-81
| |
Collapse
|
7
|
Janssens E, Mol Z, Vandermeersch L, Lagniau S, Vermaelen KY, van Meerbeeck JP, Walgraeve C, Marcq E, Lamote K. Headspace Volatile Organic Compound Profiling of Pleural Mesothelioma and Lung Cancer Cell Lines as Translational Bridge for Breath Research. Front Oncol 2022; 12:851785. [PMID: 35600344 PMCID: PMC9120820 DOI: 10.3389/fonc.2022.851785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/29/2022] [Indexed: 01/05/2023] Open
Abstract
IntroductionMalignant pleural mesothelioma (MPM) is a lethal cancer for which early-stage diagnosis remains a major challenge. Volatile organic compounds (VOCs) in breath proved to be potential biomarkers for MPM diagnosis, but translational studies are needed to elucidate which VOCs originate from the tumor itself and thus are specifically related to MPM cell metabolism.MethodsAn in vitro model was set-up to characterize the headspace VOC profiles of six MPM and two lung cancer cell lines using thermal desorption-gas chromatography-mass spectrometry. A comparative analysis was carried out to identify VOCs that could discriminate between MPM and lung cancer, as well as between the histological subtypes within MPM (epithelioid, sarcomatoid and biphasic).ResultsVOC profiles were identified capable of distinguishing MPM (subtypes) and lung cancer cells with high accuracy. Alkanes, aldehydes, ketones and alcohols represented many of the discriminating VOCs. Discrepancies with clinical findings were observed, supporting the need for studies examining breath and tumor cells of the same patients and studying metabolization and kinetics of in vitro discovered VOCs in a clinical setting.ConclusionWhile the relationship between in vitro and in vivo VOCs is yet to be established, both could complement each other in generating a clinically useful breath model for MPM.
Collapse
Affiliation(s)
- Eline Janssens
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Infla-Med Center of Excellence, University of Antwerp, Antwerp, Belgium
| | - Zoë Mol
- Department of Green Chemistry and Technology, Environmental Organic Chemistry and Technology (EnVOC) Research Group, Ghent University, Ghent, Belgium
| | - Lore Vandermeersch
- Department of Green Chemistry and Technology, Environmental Organic Chemistry and Technology (EnVOC) Research Group, Ghent University, Ghent, Belgium
| | - Sabrina Lagniau
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
- Tumor Immunology Lab, Ghent University, Ghent, Belgium
| | - Karim Y. Vermaelen
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
- Tumor Immunology Lab, Ghent University, Ghent, Belgium
| | - Jan P. van Meerbeeck
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Infla-Med Center of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- Department of Pulmonology and Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Christophe Walgraeve
- Department of Green Chemistry and Technology, Environmental Organic Chemistry and Technology (EnVOC) Research Group, Ghent University, Ghent, Belgium
| | - Elly Marcq
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Antwerp, Belgium
| | - Kevin Lamote
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Infla-Med Center of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- *Correspondence: Kevin Lamote,
| |
Collapse
|
8
|
Kabir KM, Baker MJ, Donald WA. Micro- and nanoscale sensing of volatile organic compounds for early-stage cancer diagnosis. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
9
|
Carbone M, Pass HI, Ak G, Alexander HR, Baas P, Baumann F, Blakely AM, Bueno R, Bzura. A, Cardillo G, Churpek JE, Dianzani I, De Rienzo A, Emi M, Emri S, Felley-Bosco E, Fennell DA, Flores RM, Grosso F, Hayward NK, Hesdorffer M, Hoang CD, Johansson PA, Kindler HL, Kittaneh M, Krausz T, Mansfield A, Metintas M, Minaai M, Mutti L, Nielsen M, O’Byrne K, Opitz I, Pastorino S, Pentimalli F, de Perrot M, Pritchard A, Ripley RT, Robinson B, Rusch V, Taioli E, Takinishi Y, Tanji M, Tsao AS, Tuncer AM, Walpole S, Wolf A, Yang H, Yoshikawa Y, Zolodnick A, Schrump DS, Hassan R. Medical and surgical care of mesothelioma patients and their relatives carrying germline BAP1 mutations. J Thorac Oncol 2022; 17:873-889. [DOI: 10.1016/j.jtho.2022.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022]
|
10
|
Gouzerh F, Bessière JM, Ujvari B, Thomas F, Dujon AM, Dormont L. Odors and cancer: Current status and future directions. Biochim Biophys Acta Rev Cancer 2021; 1877:188644. [PMID: 34737023 DOI: 10.1016/j.bbcan.2021.188644] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 02/07/2023]
Abstract
Cancer is the second leading cause of death in the world. Because tumors detected at early stages are easier to treat, the search for biomarkers-especially non-invasive ones-that allow early detection of malignancies remains a central goal to reduce cancer mortality. Cancer, like other pathologies, often alters body odors, and much has been done by scientists over the last few decades to assess the value of volatile organic compounds (VOCs) as signatures of cancers. We present here a quantitative review of 208 studies carried out between 1984 and 2020 that explore VOCs as potential biomarkers of cancers. We analyzed the main findings of these studies, listing and classifying VOCs related to different cancer types while considering both sampling methods and analysis techniques. Considering this synthesis, we discuss several of the challenges and the most promising prospects of this research direction in the war against cancer.
Collapse
Affiliation(s)
- Flora Gouzerh
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France; CEFE, Univ Montpellier, CNRS, EPHE, IRD, Univ Paul Valéry Montpellier 3, Montpellier, France.
| | - Jean-Marie Bessière
- Ecole Nationale de Chimie de Montpellier, Laboratoire de Chimie Appliquée, Montpellier, France
| | - Beata Ujvari
- Deakin University, School of Life and Environmental Sciences, Centre for Integrative Ecology, Waurn Ponds, Vic 3216, Australia
| | - Frédéric Thomas
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Antoine M Dujon
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France; Deakin University, School of Life and Environmental Sciences, Centre for Integrative Ecology, Waurn Ponds, Vic 3216, Australia
| | - Laurent Dormont
- CEFE, Univ Montpellier, CNRS, EPHE, IRD, Univ Paul Valéry Montpellier 3, Montpellier, France
| |
Collapse
|
11
|
Yin J, Wu M, Lin R, Li X, Ding H, Han L, Yang W, Song X, Li W, Qu H, Yu H, Li Z. Application and development trends of gas chromatography–ion mobility spectrometry for traditional Chinese medicine, clinical, food and environmental analysis. Microchem J 2021. [DOI: 10.1016/j.microc.2021.106527] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
12
|
Breath Analysis: Comparison among Methodological Approaches for Breath Sampling. Molecules 2020; 25:molecules25245823. [PMID: 33321824 PMCID: PMC7763204 DOI: 10.3390/molecules25245823] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/20/2022] Open
Abstract
Despite promising results obtained in the early diagnosis of several pathologies, breath analysis still remains an unused technique in clinical practice due to the lack of breath sampling standardized procedures able to guarantee a good repeatability and comparability of results. The most diffuse on an international scale breath sampling method uses polymeric bags, but, recently, devices named Mistral and ReCIVA, able to directly concentrate volatile organic compounds (VOCs) onto sorbent tubes, have been developed and launched on the market. In order to explore performances of these new automatic devices with respect to sampling in the polymeric bag and to study the differences in VOCs profile when whole or alveolar breath is collected and when pulmonary wash out with clean air is done, a tailored experimental design was developed. Three different breath sampling approaches were compared: (a) whole breath sampling by means of Tedlar bags, (b) the end-tidal breath collection using the Mistral sampler, and (c) the simultaneous collection of the whole and alveolar breath by using the ReCIVA. The obtained results showed that alveolar fraction of breath was relatively less affected by ambient air (AA) contaminants (p-values equal to 0.04 for Mistral and 0.002 for ReCIVA Low) with respect to whole breath (p-values equal to 0.97 for ReCIVA Whole). Compared to Tedlar bags, coherent results were obtained by using Mistral while lower VOCs levels were detected for samples (both breath and AA) collected by ReCIVA, likely due to uncorrected and fluctuating flow rates applied by this device. Finally, the analysis of all data also including data obtained by explorative analysis of the unique lung cancer (LC) breath sample showed that a clean air supply might determine a further confounding factor in breath analysis considering that lung wash-out is species-dependent.
Collapse
|
13
|
Pass HI, Alimi M, Carbone M, Yang H, Goparaju CM. Mesothelioma Biomarkers: Discovery in Search of Validation. Thorac Surg Clin 2020; 30:395-423. [PMID: 33012429 DOI: 10.1016/j.thorsurg.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Malignant pleural mesothelioma (MPM) is an asbestos-related neoplasm that can only be treated successfully when correctly diagnosed and treated early. The asbestos-exposed population is a high-risk group that could benefit from sensitive and specific blood- or tissue-based biomarkers. We review recent work with biomarker development in MPM and literature of the last 20 years on the most promising blood- and tissue-based biomarkers. Proteomic, genomic, and epigenomic platforms are covered. SMRP is the only validated blood-based biomarker with diagnostic, monitoring and prognostic value. To strengthen development and testing of MPM biomarkers, cohorts for validation must be established by enlisting worldwide collaborations.
Collapse
Affiliation(s)
- Harvey I Pass
- Research, Department of Cardiothoracic Surgery, General Thoracic Surgery, NYU Langone Medical Center, 530 First Avenue, 9V, New York, NY 10016, USA.
| | - Marjan Alimi
- Department of Cardiothoracic Surgery, NYU Langone Medical Center, 530 First Avenue, 9V, New York, NY 10016, USA
| | - Michele Carbone
- Department of Thoracic Oncology, John A. Burns School of Medicine, University of Hawaii Cancer Center, 701 Ilalo Street, Room 437, Honolulu, HI 96813, USA
| | - Haining Yang
- Department of Thoracic Oncology, John A. Burns School of Medicine, University of Hawaii Cancer Center, 701 Ilalo Street, Room 437, Honolulu, HI 96813, USA
| | - Chandra M Goparaju
- Department of Cardiothoracic Surgery, NYU Langone Medical Center, 530 First Avenue, 9V, New York, NY 10016, USA
| |
Collapse
|
14
|
Pass HI, Alimi M, Carbone M, Yang H, Goparaju CM. Mesothelioma Biomarkers: A Review Highlighting Contributions from the Early Detection Research Network. Cancer Epidemiol Biomarkers Prev 2020; 29:2524-2540. [PMID: 32699075 DOI: 10.1158/1055-9965.epi-20-0083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/22/2020] [Accepted: 07/07/2020] [Indexed: 11/16/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an asbestos-related neoplasm, which can be treated successfully only if correctly diagnosed and treated in early stages. The asbestos-exposed population serves as a high-risk group that could benefit from sensitive and specific blood- or tissue-based biomarkers. This review details the recent work with biomarker development in MPM and the contributions of the NCI Early Detection Research Network Biomarker Developmental Laboratory of NYU Langone Medical Center. The literature of the last 20 years was reviewed to comment on the most promising of the blood- and tissue-based biomarkers. Proteomic, genomic, and epigenomic platforms as well as novel studies such as "breath testing" are covered. Soluble mesothelin-related proteins (SMRP) have been characterized extensively and constitute an FDA-approved biomarker in plasma with diagnostic, monitoring, and prognostic value in MPM. Osteopontin is found to be a valuable prognostic biomarker for MPM, while its utility in diagnosis is slightly lower. Other biomarkers, such as calretinin, fibulin 3, and High-Mobility Group Box 1 (HMGB1), remain under study and need international validation trials with large cohorts of cases and controls to demonstrate any utility. The EDRN has played a key role in the development and testing of MPM biomarkers by enlisting collaborations all over the world. A comprehensive understanding of previously investigated biomarkers and their utility in screening and early diagnosis of MPM will provide guidance for further future research.See all articles in this CEBP Focus section, "NCI Early Detection Research Network: Making Cancer Detection Possible."
Collapse
Affiliation(s)
- Harvey I Pass
- Department of Cardiothoracic Surgery, NYU Langone Medical Center, New York, New York.
| | - Marjan Alimi
- Department of Cardiothoracic Surgery, NYU Langone Medical Center, New York, New York
| | - Michele Carbone
- John A. Burns School of Medicine, Department of Thoracic Oncology, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Haining Yang
- John A. Burns School of Medicine, Department of Thoracic Oncology, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Chandra M Goparaju
- Department of Cardiothoracic Surgery, NYU Langone Medical Center, New York, New York
| |
Collapse
|
15
|
Lamote K, Janssens E, Schillebeeckx E, Lapperre TS, De Winter BY, van Meerbeeck JP. The scent of COVID-19: viral (semi-)volatiles as fast diagnostic biomarkers? J Breath Res 2020; 14:042001. [DOI: 10.1088/1752-7163/aba105] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
16
|
Konings H, Stappers S, Geens M, De Winter BY, Lamote K, van Meerbeeck JP, Specenier P, Vanderveken OM, Ledeganck KJ. A Literature Review of the Potential Diagnostic Biomarkers of Head and Neck Neoplasms. Front Oncol 2020; 10:1020. [PMID: 32670885 PMCID: PMC7332560 DOI: 10.3389/fonc.2020.01020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/22/2020] [Indexed: 12/19/2022] Open
Abstract
Head and neck neoplasms have a poor prognosis because of their late diagnosis. Finding a biomarker to detect these tumors in an early phase could improve the prognosis and survival rate. This literature review provides an overview of biomarkers, covering the different -omics fields to diagnose head and neck neoplasms in the early phase. To date, not a single biomarker, nor a panel of biomarkers for the detection of head and neck tumors has been detected with clinical applicability. Limitations for the clinical implementation of the investigated biomarkers are mainly the heterogeneity of the study groups (e.g., small population in which the biomarker was tested, and/or only including high-risk populations) and a low sensitivity and/or specificity of the biomarkers under study. Further research on biomarkers to diagnose head and neck neoplasms in an early stage, is therefore needed.
Collapse
Affiliation(s)
- Heleen Konings
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Sofie Stappers
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Margot Geens
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Benedicte Y De Winter
- Laboratorium of Experimental Medicine and Pediatrics and Member of the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Kevin Lamote
- Laboratorium of Experimental Medicine and Pediatrics and Member of the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium.,Department of Pneumology, Antwerp University Hospital, Edegem, Belgium.,Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Jan P van Meerbeeck
- Laboratorium of Experimental Medicine and Pediatrics and Member of the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium.,Department of Pneumology, Antwerp University Hospital, Edegem, Belgium.,Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Pol Specenier
- Department of Oncology, Antwerp University Hospital, Edegem, Belgium.,Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium
| | - Olivier M Vanderveken
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology-Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.,Department of Translational Neurosciences, Antwerp University, Antwerp, Belgium
| | - Kristien J Ledeganck
- Laboratorium of Experimental Medicine and Pediatrics and Member of the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
17
|
Di Gilio A, Catino A, Lombardi A, Palmisani J, Facchini L, Mongelli T, Varesano N, Bellotti R, Galetta D, de Gennaro G, Tangaro S. Breath Analysis for Early Detection of Malignant Pleural Mesothelioma: Volatile Organic Compounds (VOCs) Determination and Possible Biochemical Pathways. Cancers (Basel) 2020; 12:E1262. [PMID: 32429446 PMCID: PMC7280981 DOI: 10.3390/cancers12051262] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/17/2020] [Accepted: 05/08/2020] [Indexed: 12/25/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare neoplasm, mainly caused by asbestos exposure, with a high mortality rate. The management of patients with MPM is controversial due to a long latency period between exposure and diagnosis and because of non-specific symptoms generally appearing at advanced stage of the disease. Breath analysis, aimed at the identification of diagnostic Volatile Organic Compounds (VOCs) pattern in exhaled breath, is believed to improve early detection of MPM. Therefore, in this study, breath samples from 14 MPM patients and 20 healthy controls (HC) were collected and analyzed by Thermal Desorption-Gas Chromatography-Mass Spectrometry (TD-GC/MS). Nonparametric test allowed to identify the most weighting variables to discriminate between MPM and HC breath samples and multivariate statistics were applied. Considering that MPM is an aggressive neoplasm leading to a late diagnosis and thus the recruitment of patients is very difficult, a promising data mining approach was developed and validated in order to discriminate between MPM patients and healthy controls, even if no large population data are available. Three different machine learning algorithms were applied to perform the classification task with a leave-one-out cross-validation approach, leading to remarkable results (Area Under Curve AUC = 93%). Ten VOCs, such as ketones, alkanes and methylate derivates, as well as hydrocarbons, were able to discriminate between MPM patients and healthy controls and for each compound which resulted diagnostic for MPM, the metabolic pathway was studied in order to identify the link between VOC and the neoplasm. Moreover, five breath samples from asymptomatic asbestos-exposed persons (AEx) were exploratively analyzed, processed and tested by the validated statistical method as blinded samples in order to evaluate the performance for the early recognition of patients affected by MPM among asbestos-exposed persons. Good agreement was found between the information obtained by gold-standard diagnostic methods such as computed tomography CT and model output.
Collapse
Affiliation(s)
- Alessia Di Gilio
- Department of Biology, University of Bari Aldo Moro, 70126 Bari, Italy; (L.F.); (T.M.); (G.d.G.)
- Apulian Breath Analysis Center (CeRBA), IRCCS Giovanni Paolo II, 70124 Bari, Italy; (A.C.); (N.V.); (D.G.)
| | - Annamaria Catino
- Apulian Breath Analysis Center (CeRBA), IRCCS Giovanni Paolo II, 70124 Bari, Italy; (A.C.); (N.V.); (D.G.)
- Thoracic Oncology Unit, IRCCS, Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy
| | - Angela Lombardi
- Section of Bari, National Institute for Nuclear Physics, 70126 Bari, Italy; (A.L.); (S.T.)
| | - Jolanda Palmisani
- Department of Biology, University of Bari Aldo Moro, 70126 Bari, Italy; (L.F.); (T.M.); (G.d.G.)
- Apulian Breath Analysis Center (CeRBA), IRCCS Giovanni Paolo II, 70124 Bari, Italy; (A.C.); (N.V.); (D.G.)
| | - Laura Facchini
- Department of Biology, University of Bari Aldo Moro, 70126 Bari, Italy; (L.F.); (T.M.); (G.d.G.)
- Apulian Breath Analysis Center (CeRBA), IRCCS Giovanni Paolo II, 70124 Bari, Italy; (A.C.); (N.V.); (D.G.)
| | - Teresa Mongelli
- Department of Biology, University of Bari Aldo Moro, 70126 Bari, Italy; (L.F.); (T.M.); (G.d.G.)
- Apulian Breath Analysis Center (CeRBA), IRCCS Giovanni Paolo II, 70124 Bari, Italy; (A.C.); (N.V.); (D.G.)
| | - Niccolò Varesano
- Apulian Breath Analysis Center (CeRBA), IRCCS Giovanni Paolo II, 70124 Bari, Italy; (A.C.); (N.V.); (D.G.)
- Thoracic Oncology Unit, IRCCS, Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy
| | - Roberto Bellotti
- Department of Physics, University of Bari Aldo Moro, 70126 Bari, Italy;
| | - Domenico Galetta
- Apulian Breath Analysis Center (CeRBA), IRCCS Giovanni Paolo II, 70124 Bari, Italy; (A.C.); (N.V.); (D.G.)
- Thoracic Oncology Unit, IRCCS, Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy
| | - Gianluigi de Gennaro
- Department of Biology, University of Bari Aldo Moro, 70126 Bari, Italy; (L.F.); (T.M.); (G.d.G.)
- Apulian Breath Analysis Center (CeRBA), IRCCS Giovanni Paolo II, 70124 Bari, Italy; (A.C.); (N.V.); (D.G.)
| | - Sabina Tangaro
- Section of Bari, National Institute for Nuclear Physics, 70126 Bari, Italy; (A.L.); (S.T.)
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, 70126 Bari, Italy
| |
Collapse
|
18
|
Sinha S, Swift AJ, Kamil MA, Matthews S, Bull MJ, Fisher P, De Fonseka D, Saha S, Edwards JG, Johns CS. The role of imaging in malignant pleural mesothelioma: an update after the 2018 BTS guidelines. Clin Radiol 2020; 75:423-432. [PMID: 32081346 DOI: 10.1016/j.crad.2019.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/04/2019] [Indexed: 02/07/2023]
Abstract
Malignant pleural mesothelioma (MPM) is a primary malignancy of the pleura and is associated with a poor outcome. The symptoms and signs of malignant mesothelioma present late in the natural history of the disease and are non-specific, making the diagnosis challenging and imaging key. In 2018, the British Thoracic Society (BTS) updated the guideline on diagnosis, staging, and follow-up of patients with MPM. These recommendations are discussed in this review of the current literature on imaging of MPM. It is estimated MPM will continue to cause serious morbidity and mortality in the UK late into the 21st century, and internationally, people continue to be exposed to asbestos. We aim to update the reader on current and future imaging strategies, which could aid early diagnosis of pleural malignancy and provide an update on staging and assessment of tumour response.
Collapse
Affiliation(s)
- S Sinha
- Department of Radiology, Sheffield Teaching Hospitals, Sheffield, UK
| | - A J Swift
- Department of Radiology, Sheffield Teaching Hospitals, Sheffield, UK; Academic Unit of Radiology, The University of Sheffield, Sheffield, UK
| | - M A Kamil
- Department of Radiology, Sheffield Teaching Hospitals, Sheffield, UK
| | - S Matthews
- Department of Radiology, Sheffield Teaching Hospitals, Sheffield, UK
| | - M J Bull
- Department of Radiology, Sheffield Teaching Hospitals, Sheffield, UK
| | - P Fisher
- Department of Oncology, Sheffield Teaching Hospitals, Sheffield, UK
| | - D De Fonseka
- Department of Respiratory Medicine, Sheffield Teaching Hospitals, Sheffield, UK
| | - S Saha
- Department of Respiratory Medicine, Sheffield Teaching Hospitals, Sheffield, UK
| | - J G Edwards
- Department of Thoracic Surgery, Sheffield Teaching Hospitals, Sheffield, UK
| | - C S Johns
- Department of Radiology, Sheffield Teaching Hospitals, Sheffield, UK.
| |
Collapse
|
19
|
Töreyin ZN, Ghosh M, Göksel Ö, Göksel T, Godderis L. Exhaled Breath Analysis in Diagnosis of Malignant Pleural Mesothelioma: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1110. [PMID: 32050546 PMCID: PMC7036862 DOI: 10.3390/ijerph17031110] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 12/12/2022]
Abstract
Malignant pleural mesothelioma (MPM) is mainly related to previous asbestos exposure. There is still dearth of information on non-invasive biomarkers to detect MPM at early stages. Human studies on exhaled breath biomarkers of cancer and asbestos-related diseases show encouraging results. The aim of this systematic review was to provide an overview on the current knowledge about exhaled breath analysis in MPM diagnosis. A systematic review was conducted on MEDLINE (PubMed), EMBASE and Web of Science databases to identify relevant studies. Quality assessment was done by the Newcastle-Ottawa Scale. Six studies were identified, all of which showed fair quality and explored volatile organic compounds (VOC) based breath profile using Gas Chromatography Coupled to Mass Spectrometry (GC-MS), Ion Mobility Spectrometry Coupled to Multi-capillary Columns (IMS-MCC) or pattern-recognition technologies. Sample sizes varied between 39 and 330. Some compounds (i.e, cyclohexane, P3, P5, P50, P71, diethyl ether, limonene, nonanal, VOC IK 1287) that can be indicative of MPM development in asbestos exposed population were identified with high diagnostic accuracy rates. E-nose studies reported breathprints being able to distinguish MPM from asbestos exposed individuals with high sensitivity and a negative predictive value. Small sample sizes and methodological diversities among studies limit the translation of results into clinical practice. More prospective studies with standardized methodologies should be conducted on larger populations.
Collapse
Affiliation(s)
- Zehra Nur Töreyin
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
| | - Manosij Ghosh
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
| | - Özlem Göksel
- Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Laboratory of Occupational and Environmental Respiratory Diseases, Bornova, 35100 Izmir, Turkey;
| | - Tuncay Göksel
- Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Bornova, 35100 Izmir, Turkey;
| | - Lode Godderis
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
- Idewe, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
| |
Collapse
|
20
|
van Geffen WH, Lamote K, Costantini A, Hendriks LEL, Rahman NM, Blum TG, van Meerbeeck J. The electronic nose: emerging biomarkers in lung cancer diagnostics. Breathe (Sheff) 2020; 15:e135-e141. [PMID: 32280381 PMCID: PMC7121878 DOI: 10.1183/20734735.0309-2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Lung cancer is very common and the most common cause of cancer death worldwide. Despite recent progress in the systemic treatment of lung cancer (checkpoint inhibitors and tyrosine kinase inhibitors), each year, >1.5 million people die due to this disease. Most lung cancer patients already have advanced disease at the time of diagnosis. Computed tomography screening of high-risk individuals can detect lung cancer at an earlier stage but at a cost of false-positive findings. Biomarkers could lead towards a reduction of these false-positive findings and earlier lung cancer diagnosis, and have the potential to improve outcomes and treatment monitoring. To date, there is a lack of such biomarkers for lung cancer and other thoracic malignancies, although electronic nose (e-nose)-derived biomarkers are of interest. E-nose techniques using exhaled breath component measurements can detect lung cancer with a sensitivity ranging from 71% to 96% and specificity from 33 to 100%. In some case series, such results have been validated but this is mostly using internal validation and hence, more work is needed. Furthermore, standardised sampling and analysis methods are lacking, impeding interstudy comparison and clinical implementation. In this narrative review, we provide an overview of the currently available data on E-nose technology for lung cancer detection.
Collapse
Affiliation(s)
- Wouter H van Geffen
- Dept of Pulmonary Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Kevin Lamote
- Dept of Pulmonology, Antwerp University Hospital, Edegem, Belgium.,Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Infla-Med Consortium of Excellence, University of Antwerp, Antwerp, Belgium.,Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - Adrien Costantini
- Dept of Respiratory Diseases and Thoracic Oncology, APHP, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | - Lizza E L Hendriks
- Dept of Pulmonary Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Najib M Rahman
- Oxford Respiratory Trials Unit, Nuffield Dept of Medicine, University of Oxford, Oxford, UK.,Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - Torsten G Blum
- Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Germany
| | - Jan van Meerbeeck
- Dept of Pulmonology, Antwerp University Hospital, Edegem, Belgium.,Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Infla-Med Consortium of Excellence, University of Antwerp, Antwerp, Belgium.,Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| |
Collapse
|
21
|
Catino A, de Gennaro G, Di Gilio A, Facchini L, Galetta D, Palmisani J, Porcelli F, Varesano N. Breath Analysis: A Systematic Review of Volatile Organic Compounds (VOCs) in Diagnostic and Therapeutic Management of Pleural Mesothelioma. Cancers (Basel) 2019; 11:E831. [PMID: 31207975 PMCID: PMC6627570 DOI: 10.3390/cancers11060831] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 05/31/2019] [Accepted: 06/11/2019] [Indexed: 12/16/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare neoplasm related to asbestos exposure and with high mortality rate. The management of patients with MPM is complex and controversial, particularly with regard to early diagnosis. In the last few years, breath analysis has been greatly implemented with this aim. In this review the strengths of breath analysis and preliminary results in searching breath biomarkers of MPM are highlighted and discussed, respectively. Through a systematic electronic literature search, collecting papers published from 2000 until December 2018, fifteen relevant scientific papers were selected. All papers considered were prospective, comparative, observational case-control studies although every single one pilot and based on a relatively small number of samples. The identification of diagnostic VOCs pattern, through breath sample characterization and the statistical data treatment, allows to obtain a strategic information for clinical diagnostics. To date the collected data provide just preliminary information and, despite the promising results and diagnostic accuracy, conclusions cannot be generalized due to the limited number of individuals included in each cohort study. Furthermore none of studies was externally validated, although validation process is a necessary step towards clinical implementation. Breathomics-based biomarker approach should be further explored to confirm and validate preliminary findings and to evaluate its potential role in monitoring the therapeutic response.
Collapse
Affiliation(s)
- Annamaria Catino
- Thoracic Oncology Unit, Clinical Cancer Centre "Giovanni Paolo II", 70124 Bari, Italy.
| | | | | | - Laura Facchini
- Department of Biology, University of Bari, 70125 Bari, Italy.
| | - Domenico Galetta
- Thoracic Oncology Unit, Clinical Cancer Centre "Giovanni Paolo II", 70124 Bari, Italy.
| | | | | | - Niccolò Varesano
- Thoracic Oncology Unit, Clinical Cancer Centre "Giovanni Paolo II", 70124 Bari, Italy.
| |
Collapse
|
22
|
Gao Y, Li W, Chen J, Wang X, Lv Y, Huang Y, Zhang Z, Xu F. Pharmacometabolomic prediction of individual differences of gastrointestinal toxicity complicating myelosuppression in rats induced by irinotecan. Acta Pharm Sin B 2019; 9:157-166. [PMID: 30766787 PMCID: PMC6362258 DOI: 10.1016/j.apsb.2018.09.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/21/2018] [Accepted: 08/30/2018] [Indexed: 12/13/2022] Open
Abstract
Pharmacometabolomics has been already successfully used in toxicity prediction for one specific adverse effect. However in clinical practice, two or more different toxicities are always accompanied with each other, which puts forward new challenges for pharmacometabolomics. Gastrointestinal toxicity and myelosuppression are two major adverse effects induced by Irinotecan (CPT-11), and often show large individual differences. In the current study, a pharmacometabolomic study was performed to screen the exclusive biomarkers in predose serums which could predict late-onset diarrhea and myelosuppression of CPT-11 simultaneously. The severity and sensitivity differences in gastrointestinal toxicity and myelosuppression were judged by delayed-onset diarrhea symptoms, histopathology examination, relative cytokines and blood cell counts. Mass spectrometry-based non-targeted and targeted metabolomics were conducted in sequence to dissect metabolite signatures in predose serums. Eventually, two groups of metabolites were screened out as predictors for individual differences in late-onset diarrhea and myelosuppression using binary logistic regression, respectively. This result was compared with existing predictors and validated by another independent external validation set. Our study indicates the prediction of toxicity could be possible upon predose metabolic profile. Pharmacometabolomics can be a potentially useful tool for complicating toxicity prediction. Our findings also provide a new insight into CPT-11 precision medicine.
Collapse
Key Words
- AUC-ROC, area under receiver operating characteristic
- BHB, β-hydroxybutyric acid
- Biomarkers
- C, control group
- CA, cholic acid
- CPT-11, irinotecan
- Complicating toxicity
- DBIL, direct bilirubin
- DCA, deoxycholic acid
- Diarrhea
- FDR, false discovery rate
- GCA, glycocholic acid
- Gastrointestinal toxicity
- IBIL, indirect bilirubin
- IT-TOF/MS, ion trap/time-offlight hybrid mass spectrometry
- Individual differences
- Irinotecan
- Lys, lysine
- MSTFA, N-methyl-N-trifluoroacetamide
- Metabolomics
- NS, non-sensitive group
- NSgt, non-sensitive for gastrointestinal toxicity
- NSmt, non-sensitive for myelosuppression toxicity
- OPLS-DA, orthogonal partial least-squares-discriminant analysis
- PCA, principal component analysis
- PLS-DA, partial least-squares-discriminant analysis
- Phe, phenylalanine
- Prediction
- QC, quality control
- RSD, relative standard deviation
- S, sensitive group
- Sgt, sensitive for gastrointestinal toxicity
- Smt, sensitive for myelosuppression toxicity
- T, CPT-11 treated group
- Trp, tryptophan
- UFLC, ultrafast liquid chromatography
- VIP, variable importance in the projection
- pFDR, false-discovery-rate-adjusted P value
Collapse
Affiliation(s)
- Yiqiao Gao
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education), State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing 210009, China
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China
| | - Wei Li
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education), State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing 210009, China
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China
| | - Jiaqing Chen
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education), State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing 210009, China
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China
| | - Xu Wang
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education), State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing 210009, China
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China
| | - Yingtong Lv
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education), State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing 210009, China
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China
| | - Yin Huang
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education), State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing 210009, China
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China
| | - Zunjian Zhang
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education), State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing 210009, China
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China
| | - Fengguo Xu
- Key Laboratory of Drug Quality Control and Pharmacovigilance (Ministry of Education), State Key Laboratory of Natural Medicine, China Pharmaceutical University, Nanjing 210009, China
- Jiangsu Key Laboratory of Drug Screening, China Pharmaceutical University, Nanjing 210009, China
| |
Collapse
|
23
|
Rosskamp M, Macq G, Nackaerts K, Praet M, Van Eycken L, Van Meerbeeck JP, De Schutter H. Real-life treatment practice for malignant pleural mesothelioma in Belgium. Lung Cancer 2018; 125:258-264. [DOI: 10.1016/j.lungcan.2018.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/13/2018] [Accepted: 10/06/2018] [Indexed: 01/27/2023]
|
24
|
Brusselmans L, Arnouts L, Millevert C, Vandersnickt J, van Meerbeeck JP, Lamote K. Breath analysis as a diagnostic and screening tool for malignant pleural mesothelioma: a systematic review. Transl Lung Cancer Res 2018; 7:520-536. [PMID: 30450290 PMCID: PMC6204411 DOI: 10.21037/tlcr.2018.04.09] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/10/2018] [Indexed: 12/14/2022]
Abstract
Malignant pleural mesothelioma (MPM) is a tumour related to a historical exposure to asbestos fibres. Currently, the definite diagnosis is made only by the histological examination of a biopsy obtained through an invasive thoracoscopy. However, diagnosis is made too late for curative treatment because of non-specific symptoms mainly appearing at advanced stage disease. Hence, due to its biologic aggressiveness and the late diagnosis, survival rate is low and the patients' outcome poor. In addition, radiological imaging, like computed tomographic scans, and blood biomarkers are found not to be sensitive enough to be used as an early diagnostic tool. Detection in an early stage is assumed to improve the patients' outcome but is hampered due to non-specific and late symptomology. Hence, there is a need for a new screening and diagnostic test which could improve the patients' outcome. Despite extensive research has focused on blood biomarkers, not a single has been shown clinically useful, and therefore research recently shifted to "breathomics" techniques to recognize specific volatile organic compounds (VOCs) in the breath of the patient as potential non-invasive biomarkers for disease. In this review, we summarize the acquired knowledge about using breath analysis for diagnosing and monitoring MPM and asbestos-related disorders (ARD). Gas chromatography-mass spectrometry (GC-MS), the gold standard of breath analysis, appears to be the method with the highest accuracy (97%) to differentiate MPM patients from at risk asbestos-exposed subjects. There have already been found some interesting biomarkers that are significantly elevated in asbestosis (NO, 8-isoprostane, leukotriene B4, α-Pinene…) and MPM (cyclohexane) patients. Regrettably, the different techniques and the plethora of studies suffer some limitations. Most studies are pilot studies with the inclusion of a limited number of patients. Nevertheless, given the promising results and easy sampling methods, we can conclude that breath analysis may become a useful tool in the future to screen for MPM, but further research is warranted.
Collapse
Affiliation(s)
- Lisa Brusselmans
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
| | - Lieselot Arnouts
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
| | - Charissa Millevert
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
| | - Joyce Vandersnickt
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
| | - Jan P. van Meerbeeck
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
- Internal Medicine, Ghent University, Ghent, Belgium
- Department of Pneumology, Antwerp University Hospital, Edegem, Belgium
| | - Kevin Lamote
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
- Internal Medicine, Ghent University, Ghent, Belgium
| |
Collapse
|