A real-world assessment of stage I lung cancer through electronic nose technology Journal Article
| Authors: | Rocco, G.; Pennazza, G.; Tan, K. S.; Vanstraelen, S.; Santonico, M.; Corba, R. J.; Park, B. J.; Sihag, S.; Bott, M. J.; Crucitti, P.; Isbell, J. M.; Ginsberg, M. S.; Weiss, H.; Incalzi, R. A.; Finamore, P.; Longo, F.; Zompanti, A.; Grasso, S.; Solomon, S. B.; Vincent, A.; McKnight, A.; Cirelli, M.; Voli, C.; Kelly, S.; Merone, M.; Molena, D.; Gray, K.; Huang, J.; Rusch, V. W.; Bains, M. S.; Downey, R. J.; Adusumilli, P. S.; Jones, D. R. |
| Article Title: | A real-world assessment of stage I lung cancer through electronic nose technology |
| Abstract: | Introduction: Electronic nose (E-nose) technology has reported excellent sensitivity and specificity in the setting of lung cancer screening. However, the performance of E-nose specifically for early-stage tumors remains unclear. Therefore, the aim of our study was to assess the diagnostic performance of E-nose technology in clinical stage I lung cancer. Methods: This phase IIc trial (NCT04734145) included patients diagnosed with a single greater than or equal to 50% solid stage I nodule. Exhalates were prospectively collected from January 2020 to August 2023. Blinded bioengineers analyzed the exhalates, using E-nose technology to determine the probability of malignancy. Patients were stratified into three risk groups (low-risk, [<0.2]; moderate-risk, [≥0.2–0.7]; high-risk, [≥0.7]). The primary outcome was the diagnostic performance of E-nose versus histopathology (accuracy and F1 score). The secondary outcome was the clinical performance of the E-nose versus clinicoradiological prediction models. Results: Based on the predefined cutoff (<0.20), E-nose agreed with histopathologic results in 86% of cases, achieving an F1 score of 92.5%, based on 86 true positives, two false negatives, and 12 false positives (n = 100). E-nose would refer fewer patients with malignant nodules to observation (low-risk: 2 versus 9 and 11, respectively; p = 0.028 and p = 0.011) than would the Swensen and Brock models and more patients with malignant nodules to treatment without biopsy (high-risk: 27 versus 19 and 6, respectively; p = 0.057 and p < 0.001). Conclusions: In the setting of clinical stage I lung cancer, E-nose agrees well with histopathology. Accordingly, E-nose technology can be used in addition to imaging or as part of a “multiomics” platform. © 2024 International Association for the Study of Lung Cancer |
| Keywords: | controlled study; human tissue; aged; major clinical study; histopathology; cancer staging; sensitivity and specificity; phase 2 clinical trial; cohort analysis; cancer screening; lung cancer; prediction; risk factor; biopsy; false negative result; training; probability; diagnosis; bronchoscopy; clinical decision making; false positive result; chronic obstructive lung disease; receiver operating characteristic; lung nodule; diagnostic test accuracy study; fine needle aspiration biopsy; stage i; classifier; human; male; female; article; multiomics; e-nose; sleep apnea syndromes |
| Journal Title: | Journal of Thoracic Oncology |
| Volume: | 19 |
| Issue: | 9 |
| ISSN: | 1556-0864 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2024-09-01 |
| Start Page: | 1272 |
| End Page: | 1283 |
| Language: | English |
| DOI: | 10.1016/j.jtho.2024.05.006 |
| PUBMED: | 38762120 |
| PROVIDER: | scopus |
| PMCID: | PMC11380592 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Gaetano Rocco -- Source: Scopus |
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