IASLC 19th World Conference On Lung Cancer
Toronto, Canada, 23-26 Sep 2018
The IASLC 19th World Conference on Lung Cancer will be taking place in Toronto, Canada on 23rd - 26th September 2018.
The conference is the world’s largest meeting dedicated to lung cancer and other thoracic malignancies. Attendees include surgeons, medical oncologists, radiation oncologists, pulmonologists, radiologists, pathologists, epidemiologists, basic research scientists, nurses and allied health professionals and patients. The conference also offers incredible opportunities for networking and collaboration.
Owlstone Medical's Head of Clinical Dr Marc van der Schee will be giving a presentation entitled "LuCID Exhaled Breath Analysis" at 14.15 - 14.30 on Wednesday 26th September 2018 in Room 206F.
The Breath Biopsy platform enables the collection and analysis of breath samples, in order to look for volatile organic compound (VOC) biomarkers of disease. The LuCID (lung cancer indicator detection) project is one of the first major deployments of the platform in a research setting, and is currently the largest breath-based trial in the world, recruiting up to 4000 patients. The aim of the LuCID project is to discover VOC biomarkers in breath for early detection of lung cancer, which could improve patient outcomes and save lives. In this talk, we will give an introduction to the LuCID program, then go on to describe the biology underlying the VOC biomarkers, before discussing the inherent challenges associated with breath sampling and analysis. We will conclude by giving an update on the progress of the LuCID trial to date.
The LuCID Study
LuCID is an international multi-centre prospective case-control cohort study (ClinicalTrials.gov ID NCT02612532) currently in progress, evaluating breath VOCs in patients with a clinical suspicion of lung cancer. A clinical suspicion is based on symptoms and/or suspicious finding on incidental imaging. Using tidal breathing, patients breathe into the ReCIVA Breath Sampler to collect breath samples on stable sorbent tubes for later analysis by Gas Chromatography-Mass Spectrometry and Field Asymmetric Ion Mobility Spectrometry (FAIMS, Owlstone Medical Ltd). One arm of the study is focused on early detection of lung cancer, with the aim of increasing the number of cases diagnosed at Stages 1 and 2, while an additional arm is currently being initiated looking at differences in breath profiles pre- and post-surgery which has the advantage of allowing the patient to act as their own control.
The Biology of VOCs
So why would we believe that VOC biomarkers for lung cancer could be discovered during LuCID? Cancer cells undergo profound changes of their metabolism in order to support high energetic demands of uncontrolled proliferation. Several oncogenic mutations have been shown to affect metabolism of cancer cells by converging to common metabolic pathways linked to cell cycle and anabolic growth. The Warburg effect is among well-established cancer metabolic hallmarks and entails the activation of aerobic glycolysis as main pathway for biosynthetic purposes, as opposed to normal cells that exploit mitochondrial metabolism for their energetic needs. These changes in cellular metabolism favor survival in an oxygen deprived environment and result in altered metabolic intermediates that function as the building blocks for new cells, both enabling the growth of rapidly dividing cancer cells, and also altering the profile of VOCs in breath. As these processes are fundamental to cancer cell survival, such altered metabolism occurs as one of the earliest stages of tumorigenesis, hence VOCs are excellent candidate biomarkers for early detection of cancer.
Breath Sampling: Challenges and Solutions
The potential of using breath sampling to identify markers of disease has long been recognised, but has to date seen almost no adoption into clinical practice, with only FeNO and H. pylori breath tests in widespread use. This has largely been due to practical considerations that have made large-scale clinical trials impractical to carry out. Most previous tests have involved collecting breath in bags, which
- suffer from chemical losses over time
- are vulnerable to contamination from ambient air if they are reused incorrectly
- are difficult to transport and store.
- only allow the collection of smaller volumes, limiting the sensitivity of the analysis.
In this section, we will discuss how the ReCIVA breath sampler, a key part of the Breath Biopsy platform, allows these problems to be overcome, and we will present data, including VOC washout curves monitoring changes in VOC levels over time following ingestion of a peppermint capsule, that demonstrate how the ReCIVA performs in practice.
To meet with us at this event, please get in touch.
For press information please contact:
Sarah Jeffery, Zyme Communications
+44 (0)7771 730919
Learn more about breath biomarkers for disease in our free ebook: Breath Biopsy: The Complete Guide.