Doctors recognize mesothelioma as an aggressive and deadly cancer. One of the reasons it is so lethal is because the diagnosis tends only to come after symptoms begin to show. Mesothelioma can take years, if not decades, to manifest. As a result, this disease is usually detected in a more advanced stage of the cancer. The patient’s delicate state often rules out curative treatment. Despite, and because of this, researchers have focused on early detection methods that will get patients treatment sooner to achieve better outcomes.
One recent advancement includes a new biopsy breath test – a non-invasive breath-based biomarker approach to early diagnosis. This method involves analyzing exhaled breath, which contains valuable information on cell and tissue metabolism. To collect the breath samples, participants are to breathe into a mask for twelve minutes. Performing tests in this manner avoids the more invasive and direct lung biopsies enabling healing of the lungs, which is particularly important for a condition aggravated by inflammation of the tissue. Volatile organic compounds (VOCs) are excreted in the breath and can be detected through this test, potentially identifying lung cancer at an earlier stage. Earlier detection will help reduce the high mortality rate for mesothelioma. Unfortunately, an impediment to progress here is that VOCs can be hard to spot in the breath and are excreted in low concentrations.
Researchers are still making strides in research despite the challenges posed with analyzing VOCs. A more recent validation study in the European Respiratory Journal determined the most important VOCs for diagnosing mesothelioma, including P1, P3, P7, P9, P21, and P26. In the study, these specific markers indicated malignant mesothelioma with accuracy. The cancer was correctly identified against control groups of asymptomatic former asbestos workers or patients with benign non-asbestos related lung diseases. The breath test even differentiated those with mesothelioma from a group that had lung cancer. This study goes beyond measuring against a healthy group to determine the breath test’s accuracy and demonstrates that the precision is improving.
There continue to be advancements for the breath test, but during the COVID-19 pandemic, organizers canceled many symposiums that host clinical trials. Cancellations include the much-anticipated clinical trial by Dr. Harbut, whose goal was to reaffirm the findings of a Belgium study analyzing patients’ breath from 2018, where they were able to diagnose with 96% accuracy. Gas chromatography-mass spectrometry (GC-MS) is considered the gold standard of breath analysis with the highest accuracy rate at 97% with differentiating patient diagnoses, but it can be costly. They have also been able to train dogs to smell the breath samples for cancer biomarkers, but this is also costly. Another limitation is that many studies are ultimately using sample sizes that are too small due to mesothelioma’s rare nature. These limitations are why multiple studies need to be performed to confirm the findings and why the work of Dr. Harbut is critical.
One contemporary answer to the constraints of GC-MS costs or training dogs is a new alternative with electronic noses or eNoses. This device is a form of sensor technology that recognizes VOC breath patterns that researchers refer to as a “smellprint.” This method is fast and appears less costly but is not as specific with its VOC identification. The continued research into which biomarkers to look for is made easier as the technology behind measuring and analyzing the data from breath tests advances. These advances hold especially meaningful implications for performing larger studies due to their less invasive nature.
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