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J Breath Res

Title:		Determining the clinical utility of a breath test for screening an asbestos-exposed population for pleural mesothelioma: baseline results
Author(s):		Zwijsen K; Schillebeeckx E; Janssens E; Cleemput JV; Richart T; Surmont VF; Nackaerts K; Marcq E; van Meerbeeck JP; Lamote K;
Address:		"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. Occupational Health Service, Eternit N.V., 1880 Kapelle-op-den-Bos, Belgium. Idewe vzw, 3000 Leuven, Belgium. Department of Respiratory Medicine, Ghent University Hospital, 9000 Ghent, Belgium. Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium. Department of Respiratory Medicine, University Hospital Gasthuisberg, 3000 Leuven, Belgium. Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, 2610 Antwerp, Belgium. Department of Pulmonology & Thoracic Oncology, Antwerp University Hospital, 2650 Edegem, Belgium"
Journal Title:		J Breath Res
Year:		2023
Volume:		20230921
Issue:		4
Page Number:		-
DOI:		10.1088/1752-7163/acf7e3
ISSN/ISBN:		1752-7163 (Electronic) 1752-7155 (Linking)
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)"
Keywords:		Humans Breath Tests *Mesothelioma/diagnostic imaging *Pleural Neoplasms/diagnostic imaging *Asbestos/adverse effects *Body Fluids asbestos biomarker breathomics early detection pleural mesothelioma screening volatomics;
Notes:		"MedlineZwijsen, Kathleen Schillebeeckx, Eline Janssens, Eline Cleemput, Joris Van Richart, Tom Surmont, Veerle F Nackaerts, Kristiaan Marcq, Elly van Meerbeeck, Jan P Lamote, Kevin eng Research Support, Non-U.S. Gov't England 2023/09/09 J Breath Res. 2023 Sep 21; 17(4). doi: 10.1088/1752-7163/acf7e3"