Breath Analysis For Lung Cancer Early Detection Ori Liran a, Manal Abud-Hawa b, Maya Ilouze a,c, Naomi Gai-Mor a, Shlomi Dekel a, Alon Ben-Nun d, Amir.

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Breath Analysis For Lung Cancer Early Detection Ori Liran a, Manal Abud-Hawa b, Maya Ilouze a,c, Naomi Gai-Mor a, Shlomi Dekel a, Alon Ben-Nun d, Amir Onn a, Jair Bar d, Douglas Johnson e, John Wells e, Stuart Millstone e, Paul A Bunn Jr f,, York Miller f, Robert L. Keith g, Brad Rikke f, Fred R Hirsch f, Hossam Haick b and Nir Peled a,c * a Thoracic Cancer Research and Detection Center, Sheba Medical Center, Tel-Aviv, Israel; b The Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion – Israel Institute of Technology, Haifa, Israel; c Davidoff Cancer Center, Rabin Medical Center d Institute of Oncology, Sheba Medical Center, Israel; e Florida Radiation Oncology Group, Fl, USA; f University of Colorado Cancer Center, Denver, CO, USA; g Denver VA Medical Center, Denver, CO, USA Introduction 150,000 new lung nodules are detected annually in US, while only minor percentage of them is malignant. Final diagnosis requires biopsy and/or surgery. Screening for Lung Cancer was proven to reduce the related mortality by 20%. The screening program suffers from high false positivity (96% out of the 24% positive CT scans; NLST study). Volatile Organic Compounds (VOCs) are organic metabolites that are released by the cancer cells and/or by the surrounding environment. Our previous studies showed that: Cancer cells show specific VOCs signature. Cancer cells show specific VOCs signature per histology and genetic profile. Aim of the Current Study: To detect lung cancer and its stage by exhaled breath analysis. Results Exhaled air collection: Delivering to a reference lab (Technion, Israel) : 1.Heating to evaporate the VOC in inert environment conditions. 2.Analyzing by GCMS and Artificial Olfactory System (gold Nano- Particles). Patients  358 subjects were enrolled : Israel: 174; Denver: 111; Florida: 73.  213 lung cancer patients: among 62 early disease and 143 advanced stage.  145 patients did not have cancer Florida Exhale Breath Analysis by E-nose Cell line study showing different VOCs signature in NSCLC vs. SCLC and sub-histologies (NanoMedicine 2012) Methods Lung cancer patients and matching High risk control patients were recruited to the study Conclusion: Breath analysis discriminated malignant from benign conditions in a high-risk cohort based on volatile signature. Furthermore, it discriminated between early versus advanced disease. These achievements stand in consistency with the requirements of society for rapid and early diagnosis of diseases as a part of therapeutic approach and facilitating rapid treatment. Discrimination between control and lung cancer Discrimination between early and advanced disease Israel Exhale Breath Analysis by E-nose SensitivitySpecificityAccuracy Control / LC 93.87%95.65 %94.44% Early LC /Advanced LC 83.33%91.66 %89.58% SensitivitySpecificityAccuracy ROC AUC Control / Early LC81.25%90.32%85.11% Control / Advanced LC81.25%87.10%82.11% Early LC /Advanced LC80.26%75%78.75% Discrimination between control and early lung cancer Discrimination between early and advanced disease