Volatile organic compounds and the potential for a lung cancer breath test

Detecting exhaled volatile organic compounds (VOCs) that are associated with lung cancer (LC) has realistic potential for becoming an integral part of population-based LC screening and monitoring in the near future. Here, we review the main three approaches for profiling VOCs in LC patients and their advantages and pitfalls: first, mass spectrometry techniques for the identification and/or quantification of a wide variety of separate breath VOCs; second, canines that are trained to sniff out LC; and third, cross-reactive chemical sensors in combination with statistical methods for identifying disease-specific patterns.  We estimate that the latter would be most suitable for clinical practice. In the short run, breath testing could provide a critically needed adjunct method for detecting nodule malignancy with high specificity during low-dose computed tomography screening. In the long run, breath testing holds potential for entirely revolutionizing LC screening, diagnosis and management.

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