A Breath Test for Mesothelioma?

Researchers in Belgium say a breath analysis tool could provide the next big breakthrough in the effort to diagnose malignant mesothelioma earlier.

The team, made up of scientists from Ghent and Antwerp Universities, says the technique looks “very promising” and fits well within the aims of the “National Cancer Moonshot” research initiative established by President Obama.

The Challenge of Mesothelioma Diagnosis

Malignant pleural mesothelioma (MPM) is a rare, lung-related cancer linked to asbestos exposure.

Although scientists have identified several compounds or “biomarkers” in blood or lung fluid that seem to be overproduced by mesothelioma tumors, these markers are not reliable enough to use as stand-alone diagnostic tools. Instead, they are currently used in conjunction with other diagnostic tools such as imaging tests.

The most notable mesothelioma biomarker is the protein mesothelin, which forms the basis of the MESOMARK blood test. Other mesothelioma biomarkers include fibulin-3, osteopontin, and SMRP. They are all used to help identify mesothelioma after symptoms develop.

Early Diagnosis is Key

Doctors believe that one of the best ways to improve outcomes for mesothelioma patients is to identify mesothelioma in its earliest stages, when therapeutic interventions are most likely to be effective.

Although blood and serum biomarkers are limited in their ability to do this, the Belgian researchers believe that compounds in the exhaled breath of mesothelioma patients may be a viable alternative.

Breathomics is a technique for analyzing volatile organic compounds in the breath that are produced by biochemical processes. Measuring the concentration of these compounds can provide key information about the possible presence of lung cancer or pleural mesothelioma.

“This method seems very promising in the early detection of diverse malignancies, because exhaled breath contains valuable information on cell and tissue metabolism,” writes Ghent University researcher Sabrina Lagniau in a  new article in Oncotarget.

According to the article, research that focuses on breath-based biomarkers in pleural mesothelioma is still in its early stages, but the few studies that have been done show encouraging results.

On the plus side, breath analysis is simple, non-invasive, fast, and inexpensive. On the down side, the research team says it may be more difficult with this method to tell one type of cancer from another. Research to help distinguish VOCs from one type of cancer from VOCs produced by people with another type is ongoing.

“We believe a breathomics-based biomarkers approach should be further explored to improve the follow-up and management of asbestos exposed individuals,” states the report. “Rigorous studies on large patient cohorts and appropriate controls will determine the clinical validity and utility of breathomics in the diagnosis of mesothelioma.”

Source:

Lagniau, S, et al, “Biomarkers for early diagnosis of malignant mesothelioma: Do we need another moonshot?”, May 17, 2017, Oncotarget, Epub ahead of print