title: Exhaled Breath Analysis for Monitoring Response to Treatment in Advanced Lung Cancer.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Thoracic Cancer Research and Detection Center, Sheba Medical Center, Tel-Aviv, Israel.
authors.forename: Inbar
authors.initials: I
authors.lastname: Nardi-Agmon
authors.affiliation: Department of Chemical Engineering, Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Manal
authors.initials: M
authors.lastname: Abud-Hawa
authors.affiliation: Thoracic Cancer Research and Detection Center, Sheba Medical Center, Tel-Aviv, Israel.
authors.forename: Ori
authors.initials: O
authors.lastname: Liran
authors.affiliation: Thoracic Cancer Research and Detection Center, Sheba Medical Center, Tel-Aviv, Israel.
authors.forename: Naomi
authors.initials: N
authors.lastname: Gai-Mor
authors.affiliation: Thoracic Cancer Unit, Davidoff Cancer Center, Rabin Medical Center, Israel.
authors.forename: Maya
authors.initials: M
authors.lastname: Ilouze
authors.affiliation: Thoracic Oncology Unit, Institute of Oncology, Sheba Medical Center, Tel-Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Onn
authors.affiliation: Thoracic Oncology Unit, Institute of Oncology, Sheba Medical Center, Tel-Aviv, Israel.
authors.forename: Jair
authors.initials: J
authors.lastname: Bar
authors.affiliation: Thoracic Cancer Research and Detection Center, Sheba Medical Center, Tel-Aviv, Israel.
authors.forename: Dekel
authors.initials: D
authors.lastname: Shlomi
authors.affiliation: Thoracic Oncology Unit, Institute of Oncology, Sheba Medical Center, Tel-Aviv, Israel. Electronic address: hhossam@technion.ac.il.
authors.forename: Hossam
authors.initials: H
authors.lastname: Haick
authors.affiliation: Thoracic Cancer Research and Detection Center, Sheba Medical Center, Tel-Aviv, Israel; Thoracic Cancer Unit, Davidoff Cancer Center, Rabin Medical Center, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Peled
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D001944:Breath Tests; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D045853:Exhalation; D005260:Female; D005500:Follow-Up Studies; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D066066:Response Evaluation Criteria in Solid Tumors; D055752:Small Cell Lung Carcinoma / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate; D055549:Volatile Organic Compounds / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D055549:Volatile Organic Compounds
keywords: Biomarkers; Early detection; Exhale breath; Lung cancer