E-nose: the test that can “sniff” out lung cancer
A Phase IIc clinical trial has assessed the performance of electronic-nose (E-nose) technology in diagnosing early-stage lung cancer in a real-world setting.
A multi-institutional group of researchers has demonstrated impressive sensitivity and specificity results for E-nose in detecting early-stage lung cancer, providing an alternative to invasive biopsies for thoracic malignancies.
Detecting cancer at its earliest stage widens the options for treatment, improving survival and quality of life. In this Phase IIc study, the team wished to appraise the accuracy of the E-nose device in detecting combinations of chemicals emitted by cancerous cells termed volatile organic compounds (VOCs).
In a cohort of 100 participants, aged 21–85 years of age who were referred to hospital with a lung nodule, the team found that E-nose agreed with histopathologic results in 86% of cases, achieving an F1 score of 92.5%, based on 86 true positives, two false negatives and 12 false positives.
Lead author Gaetano Rocco (Memorial Sloan Kettering, NY, USA) commented: “Our results suggest the E-nose would be an excellent addition to the current techniques for diagnosing lung cancer—and would pose no risk to the patient because it’s noninvasive. The E-nose reliably detected early-stage lung cancer and was very accurate when compared with the long-established available imaging methods.”
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The e-Nose test involves two steps, firstly the patient breathes into a collection device for a few minutes. If VOCs are present in the patient’s breath, then a USB-sized sensor transforms these electronic signals into a “breathprint”, which is then analyzed by a separate machine that can detect the presence of cancer in only a few hours.
E-nose was observed to refer fewer patients with malignant nodules to observation than would Swensen and Brock models and more patients with malignant nodules to treatment without having a biopsy. Overall, the results indicate that E-nose technology could be a useful addition to imaging or as part of a multiomics platform.
The authors also note that the technology could prove valuable in remote areas where traditional lung cancer screening options are limited.