Accuracy and Methodologic Challenges of Volatile Organic Compound–Based Exhaled Breath Tests for Cancer Diagnosis

Hanna, George B.; Boshier, Piers R.; Romano, Andrea

doi:10.1001/jamaoncol.2018.2815

Cited by 169 publications

(174 citation statements)

References 80 publications

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“…All studies were Phase I biomarker discovery studies. Of the 30 included studies, 18 were from Asia and the Far East [8,9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26], seven from Europe [27][28][29][30][31][32][33], three from North America [34][35][36], and two from the Middle East [37,38]. ASCC tumour sites identified were the head and neck (n = 17), oesophageal (n = 8), and lung (n = 5).…”

Section: Resultsmentioning

confidence: 99%

“…For example, in upper gastrointestinal adenocarcinoma (the other major ASCC subtype), exhaled metabolites have demonstrated promise for detecting treatable disease stages [8][9][10]. However, progress in this field has been hampered by inadequate standardisation, inconsistent quality assurance, and evolving analytical technology [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Biomarkers of Squamous Cell Carcinoma of the Aerodigestive Tract: A Systematic Review and Quality Assessment

Goh

Antonowicz

Boshier

et al. 2020

Oxidative Medicine and Cellular Longevity

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Introduction. Aerodigestive squamous cell carcinomas (ASCC) constitute a major source of global cancer deaths. Patients typically present with advanced, incurable disease, so new means of detecting early disease are a research priority. Metabolite quantitation is amenable to point-of-care analysis and can be performed in ASCC surrogates such as breath and saliva. The purpose of this systematic review is to summarise progress of ASCC metabolomic studies, with an emphasis on the critical appraisal of methodological quality and reporting. Method. A systematic online literature search was performed to identify studies reporting metabolic biomarkers of ASCC. This review was conducted in accordance with the recommendations of the Cochrane Library and MOOSE guidelines. Results. Thirty studies comprising 2117 patients were included in the review. All publications represented phase-I biomarker discovery studies, and none validated their findings in an independent cohort. There was heterogeneity in study design and methodological and reporting quality. Sensitivities and specificities were higher in oesophageal and head and neck squamous cell carcinomas compared to those in lung squamous cell carcinoma. The metabolic phenotypes of these cancers were similar, as was the kinetics of metabolite groups when comparing blood, tissue, and breath/saliva concentrations. Deregulation of amino acid metabolism was the most frequently reported theme. Conclusion. Metabolite analysis has shown promising diagnostic performance, especially for oesophageal and head and neck ASCC subtypes, which are phenotypically similar. However, shortcomings in study design have led to inconsistencies between studies. To support future studies and ultimately clinical adoption, these limitations are discussed.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metabolic Biomarkers of Squamous Cell Carcinoma of the Aerodigestive Tract: A Systematic Review and Quality Assessment

Goh

Antonowicz

Boshier

et al. 2020

Oxidative Medicine and Cellular Longevity

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“…A meta‐analysis of 63 studies on 3554 patients with different cancer types (mostly lung, breast and gastro‐oesophageal) has shown a sensitivity of breath testing for cancer diagnosis ranging from 28% to 100%, and a specificity of 61–100%. The overall pooled analysis showed a mean area under the receiver operating characteristic (ROC) curve of 0.9, and a pooled sensitivity and specificity of 79% (95% CI = 77–81%) and 89% (95% CI = 88–90%), respectively (Hanna et al ., ). The substantial heterogeneity between the studies, including different methods of sample collection and test environment, remains a limitation of this analysis.…”

Section: Technologies For Early Diagnosismentioning

confidence: 97%

Early detection and therapeutics

Januszewicz

Fitzgerald

2019

Molecular Oncology

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Early detection, including cancer screening and surveillance, is emerging as one of the most important topics in modern oncology. Because symptomatic presentation remains the predominant route to cancer diagnosis, there is a growing interest in developing techniques to detect the disease at an early, curative stage. Moreover, growing understanding of cancer biology has paved the way for prevention studies with the focus on therapeutic interventions for premalignant conditions. Where there is a recognisable precursor stage, such as a colorectal adenoma or Barrett's metaplasia, the removal of abnormal tissue prevents the development of cancer and enables stratification of the patient to a high‐risk group requiring further surveillance. Here, we provide a review of the available technologies for early diagnosis and minimally‐invasive treatment.

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“…Sensor response to VOCs can be analysed by pattern recognition algorithms to classify different cases individually, in which the principal component reduction and subsequent pattern recognition by discriminant analysis are the most frequently used types of raw-data analysis for their responses [5]. Other techniques are also used for data analysis, such as machine-learning algorithms and neural networks [111]. These techniques mimic the cognitive process of the human brain, containing interconnected data processing algorithms that work in parallel [110].…”

Section: Future Perspectives and Concluding Remarksmentioning

confidence: 99%

Sensors for detecting pulmonary diseases from exhaled breath

Hashoul

Haick

2019

Eur Respir Rev

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This review presents and discusses a new frontier for fast, risk-free and potentially inexpensive diagnostics of respiratory diseases by detecting volatile organic compounds (VOCs) present in exhaled breath. One part of the review is a didactic presentation of the overlaying concept and the chemistry of exhaled breath. The other part discusses diverse sensors that have been developed and used for the detection of respiratory diseases (e.g. chronic obstructive pulmonary disease, asthma, lung cancer, pulmonary arterial hypertension, tuberculosis, cystic fibrosis, obstructive sleep apnoea syndrome and pneumoconiosis) by analysis of VOCs in exhaled breath. The strengths and pitfalls are discussed and criticised, particularly in the perspective in disseminating information regarding these advances. Ideas regarding the improvement of sensors, sensor arrays, sensing devices and the further planning of workflow are also discussed.

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Accuracy and Methodologic Challenges of Volatile Organic Compound–Based Exhaled Breath Tests for Cancer Diagnosis

Cited by 169 publications

References 80 publications

Metabolic Biomarkers of Squamous Cell Carcinoma of the Aerodigestive Tract: A Systematic Review and Quality Assessment

Metabolic Biomarkers of Squamous Cell Carcinoma of the Aerodigestive Tract: A Systematic Review and Quality Assessment

Early detection and therapeutics

Sensors for detecting pulmonary diseases from exhaled breath

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