Project details


ENose and lung cancer

lung cancer biomarkers cancer patients

dr. M. van den Berge
H.J.M. Groen
Dr. T.J.N. Hiltermann

Nature of the research:

Fields of study:
immunology pulmonology oncology

Background / introduction
Lung cancer is still the number one cause of cancer related death. One of the difficulties in lung cancer is that most often symptoms only occur in later stages of disease. Therefore, when detected lung cancer is metastasized in the majority of cases. Treatment is then with palliative intent only. New noninvasive measures like analysis of condensated breath by the ENose are promising in selecting patients that are at risk for lung cancer. Immunotherapy is a new therapy for lung cancer whereby in a subpopulation prolonged responses can be seen. The current biomarkers used to predict responses to immunotherapy (PD-L1 and tumor mutational burden) are relatively poor, especially in predicting individual responses. In addition first data have been reported that the ENose may select patients that respond to immunotherapy from those that do not (Sterk et al, submitted). The ENose will be validated in different cohorts both to screen and to follow up treated patients with lung cancer, with a main focus on immunotherapy.
Research question / problem definition
1. Can the ENose predict responses to immunotherapy?
2. Can the ENose be used to screen for lung cancer
Two different cohorts:
Cohort 1: All patients starting with immunotherapy will be routinely tested for breath condensate at baseline (before starting immunotherapy) and after one course of immunotherapy
Cohort 2: All patients that show nodules on the PUSH project will routinely have a flow volume curve done as part of their work up together with an exhaled air analysis by the SpiroNose
1. de Vries R, Dagelet YWF, Spoor P, et al. Clinical and inflammatory phenotyping by breathomics in chronic airway diseases irrespective of the diagnostic label. Eur Respir J. 2018;51
2. Lamote K, Brinkman P, Vandermeersch L, et al. Breath analysis by gas chromatography-mass spectrometry and electronic nose to screen for pleural mesothelioma: A cross-sectional case-control study. Oncotarget. 2017;8(53):91593-91602.
3. Hubers AJ, Brinkman P, Boksem RJ, et al. Combined sputum hypermethylation and eNose analysis for lung cancer diagnosis. J Clin Pathol. 2014;67(8):707-711.
4. Horn L, Spigel DR, Vokes EE, et al. Nivolumab versus docetaxel in previously treated patients with advanced non-small-cell lung cancer: Two-year outcomes from two randomized, open-label, phase III trials (CheckMate 017 and CheckMate 057). J Clin Oncol. 2017;35(35):3924-3933.
5. Carbone DP, Reck M, Paz-Ares L, et al. First-line nivolumab in stage IV or recurrent non-small-cell lung cancer. N Engl J Med. 2017;376(25):2415-2426.
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