SINGAPORE: Researchers found that identifying and analysing the volatile organic chemicals in individuals' exhaled breath who had malignant pleural mesothelioma showed promise as a screening tool for MPM.

Malignant pleural mesothelioma (MPM) is a difficult condition with few curative options and a dismal outlook.

Researchers have been investigating predicting markers to enhance treatment outcomes and personalise medicines for specific patients.

Volatile organic molecules (VOCs) in exhaled breath have recently gained attention as potential non-invasive disease indicators.

Using VOCs as predictive biomarkers, Kevin Lamote, PhD, of the University of Antwerp in Belgium, and colleagues conducted a study to see if exhaled breath analysis could distinguish between treatment responders and non-responders (discriminative setup) and, if successful, predict treatment outcomes earlier (predictive setup).

13 MPM patients were reviewed by Dr. Lamote and his team, who also had them undergo CT scans before and every three months after therapy, with the results being graded as either stable (SD) or progressive (PD) based on mRECIST standards.

Multi-capillary column-ion mobility spectrometry (MCC-IMS) was used to collect breath samples and background samples from the patients at each time point in order to characterise VOCs.

To find VOCs that could distinguish between responders and non-responders following treatment, a lasso regression was carried out. Additionally, using linked breath samples from earlier research visits, a predictive model was created to predict treatment outcomes.

According to the study, identifying SD and PD patients during follow-up was 89 per cent accurate. Promisingly, the predictive model predicted treatment results with the same degree of accuracy at the outset.

Notably, there were no discernible treatment differences between SD and PD patients, indicating that the chosen VOCs may not be treatment-specific but rather implicated in general mechanisms or related to the tumor microenvironment.

“The identification of VOCs in exhaled breath represents a promising opportunity for non-invasive detection and prediction of treatment outcomes in MPM patients,” said Dr. Lamote.

“However, to further validate the utility of the VOC profile, larger population studies are required. Fine-tuning the VOC profile for each treatment could also help predict which patients are most likely to benefit from specific therapies, ultimately leading to improved overall treatment regimens for MPM.”

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