BREATH-PATH - Protocol for lung cancer management in surgical patients through analysis of breath profiles

BackgroundAnatomical surgical resection is the treatment of choice for early-stage non-small cell lung cancer (NSCLC) and is a part of the multimodality treatment for resectable, locally advanced NSCLC. Local, regional and distant recurrence is the most common cause of treatment failure after resection. Multiple studies have recommended chest computed tomography (CT) for lung cancer (LC) patients follow-up. Even though adopting this strategy, the recurrence will only be detected months after the onset of the disease once imaging changes will only occur with a high tumor burden. MethodsBreath analysis is a promising technology and useful addition to the currently available modalities to achieve lung cancer diagnosis and management. The volatile organic compounds (VOCs) produced as end-products of metabolism by the LC cells (and present on the exhaled breath of the patients) seem to have a unique pattern that can be used as a tool to detect lung cancer (VOC profile). DiscussionThe BREATH-PATH study aims to establish a VOC profile for all LC patients at diagnosis and understand its variations with the different implemented treatments in order to find response patterns. By understanding these patterns and identifying their deviations thereof with disease relapse supported by imaging methods we will be able to validate the breath analysis as a useful tool for LC recurrence detection. This study intents not only to reiterate the methods efficacy but also to understand how high its sensitivity is in detecting a tumor recurrence, allowing breath analysis to be integrated into clinical decision algorithms.