Kathleen Zwijsen at BBCon 2023

00:00 ‘Using Ion Mobility Spectrometry for Early Mesothelioma Detectionin Asbestos-Exposed Individuals: an External Validation’

12:01 Question and Answer Session

Talk Abstract:

Introduction: Pleural mesothelioma (PM) is a highly aggressive thoracic cancer characterized by a poor prognosis. Early diagnosis is crucial for improving patient outcomes, but due to its nonspecific symptoms, PM is often diagnosed at an advanced stage. Currently, there are no reliable diagnostic biomarkers or screening tools available for PM. However, exhaled breath analysis has emerged as a promising avenue for early detection, offering a non-invasive and easily obtainable sample that contains volatile organic compounds (VOCs). These VOCs have shown potential as biomarkers for various (patho)physiological processes [1]. To harness this potential, a breath test utilizing multicapillary column/ion mobility spectrometry (MCC/IMS) was recently developed, exhibiting an accuracy of 87% in distinguishing asbestos-exposed (AEx) individuals from PM patients [2]. Nonetheless, before implementing this test as a screening tool, it is crucial to establish its clinical utility through external validation.

Methods: Our prospective study enrolled individuals with significant occupational asbestos exposure that began at least 25 years ago. Participants consented to undergo four annual breath tests employing MCC/IMS, with the aim of adhering to the “test, re-test” principle and improving the false positivity rate. The breath tests are conducted annually over four consecutive years, as illustrated in Figure 1. Currently, we have completed the first and second sampling rounds (Figure 1). Any aberrant results from the first breath test will be confirmed after one year to be considered suspect for PM. Additionally, all participants will undergo a low-dose chest computed tomography (CT)
scan correlation after the second sampling round. Treatment-naive PM patients were included as controls. Given the intended use of the breath test as an exclusive screening
tool, we selected a threshold that maximizes sensitivity and negative predictive value.

Results: Our study included a total of 121 AEx individuals and 7 PM patients in the first two screening rounds. Among the AEx individuals, the breath-based model classified 55
participants as deviant in both rounds, warranting a CT scan. Notably, all 7 PM patients were correctly identified as having mesothelioma, resulting in 100% sensitivity and 100%
negative predictive value for the test.

Conclusion: Our findings demonstrate that all PM patients in our study were accurately identified as having mesothelioma, while nearly half of the high-risk cohort exhibited
repeated deviant results in the first two rounds of the breath-based test. These results hold the potential for initiating a screening program for early detection of PM in asbestos-exposed individuals using exhaled breath. The MCC/IMS-based breath test can serve as a valuable tool for ruling out the presence of the disease.

[1] Lamote, K., Eur Respir J, 2017
[2] Janssens, E., Cancers, 2022

Speaker Biography:

Kathleen Zwijsen is a PhD researcher at the University of Antwerp, specializing in biomedical sciences under the supervision of prof. Kevin Lamote and prof. Jan van Meerbeeck. Since 2022, Kathleen has been dedicated to her research on pleural mesothelioma, an aggressive asbestos-related cancer. Her work focuses on developing a non-invasive breath test for the early diagnosis of mesothelioma, aiming to improve patient outcomes through timely detection. Kathleen’s research involves externally validating the breath test,
which has shown promising results so far. To further advance biomarker development, she plans to utilize the test for the follow-up of professionally asbestos-exposed individuals at risk for PM. Her Respiratory Society, International Association of Breath Research and International Association for the Study of Lung Cancer.

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