Download Lung Cancer early detection_Poster_ISCORT 2015

Breath Analysis For Lung Cancer Early Detection
Ori Lirana, Manal Abud-Hawab, Maya Ilouzea,c, Naomi Gai-Mora, Shlomi Dekela, Alon Ben-Nund, Amir Onna, Jair Bard,
Douglas Johnsone, John Wellse, Stuart Millstonee, Paul A Bunn Jrf, , York Millerf, Robert L. Keithg, Brad Rikkef, Fred R Hirschf , Hossam Haickb and Nir Peleda,c
[email protected]
*
aThoracic
Cancer Research and Detection Center, Sheba Medical Center, Tel-Aviv, Israel; bThe Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion – Israel Institute of Technology, Haifa, Israel;
cDavidoff Cancer Center, Rabin Medical Center d Institute of Oncology, Sheba Medical Center, Israel;
e Florida Radiation Oncology Group, Fl, USA; f University of Colorado Cancer Center, Denver, CO, USA; g Denver VA Medical Center, Denver, CO, USA
Introduction
• 150,000 new lung nodules are detected annually in US,
while only minor percentage of them is malignant.
• Final diagnosis requires biopsy and/or surgery.
• Screening for Lung Cancer was proven to reduce the
related mortality by 20%.
• The screening program suffers from high false positivity
(96% out of the 24% positive CT scans; NLST study).
Methods
Results
Patients
Lung cancer patients and
matching High risk control
patients were recruited to
the study
 358 subjects were enrolled : Israel: 174; Denver: 111; Florida: 73.
 213 lung cancer patients: among 62 early disease and 143 advanced
stage.
 145 patients did not have cancer
Florida Exhale Breath Analysis by E-nose
Exhaled air collection:
Discrimination between
control and lung cancer
• Volatile Organic Compounds (VOCs) are organic
metabolites that are released by the cancer cells and/or
by the surrounding environment.
Discrimination between early
and advanced disease
8
LC
Control
6
Canonical 1
4
• Our previous studies showed that:
2
0
• Cancer cells show specific VOCs signature.
-2
LC
Control
• Cancer cells show specific VOCs signature per
histology and genetic profile.
Delivering to a reference lab (Technion, Israel) :
1. Heating to evaporate the VOC in inert environment conditions.
2. Analyzing by GCMS and Artificial Olfactory System (gold NanoParticles).
Cell line study showing different VOCs signature
in NSCLC vs. SCLC and sub-histologies
(NanoMedicine 2012)
Sensitivity
Specificity
Accuracy
Control / LC
93.87%
95.65 %
94.44%
Early LC /Advanced LC
83.33%
91.66 %
89.58%
Israel Exhale Breath Analysis by E-nose
Output
Sorbent Tube
N2 or Vacuum Input
Glass Cover
Discrimination between early
and advanced disease
Discrimination between control and
early lung cancer
2
Cell Lines
3
1
Hot Plate
GC-MS &
SPME
0
Canonical Score
Sorbent Material
Canonical Score
Thermal
Desorption
2
-1
-2
1
0
-1
-3
-2
M FC
-4
M FC
-3
Early stage
Advanced LC
Control
Early LC
M FC
Aim of the Current Study:
To detect lung cancer and its stage by exhaled
breath analysis.
Array of Au NP Chemiresistors
ROC
Sensitivity
Specificity
Accuracy
Control / Early LC
81.25%
90.32%
85.11%
0.81048
Control / Advanced LC
81.25%
87.10%
82.11%
0.83065
Early LC /Advanced LC
80.26%
75%
78.75%
0.75293
AUC
Conclusion:
Breath analysis discriminated malignant from benign conditions in a high-risk cohort based on volatile signature. Furthermore, it discriminated between early versus
advanced disease. These achievements stand in consistency with the requirements of society for rapid and early diagnosis of diseases as a part of therapeutic approach and
facilitating rapid treatment.