A Real-World Assessment of Stage I Lung Cancer Through Electronic Nose Technology.

Autor:	Rocco G; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: roccog@mskcc.org., Pennazza G; Department of Engineering, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico di Roma, Rome, Italy., Tan KS; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York., Vanstraelen S; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Santonico M; Department of Science and Technology for Sustainable Development and One Health, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico di Roma, Rome, Italy., Corba RJ; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Park BJ; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Sihag S; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Bott MJ; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Crucitti P; Department of Thoracic Surgery, Università Campus Bio-Medico di Roma, Rome, Italy., Isbell JM; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Ginsberg MS; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York., Weiss H; Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, New York., Incalzi RA; Department of Geriatrics, Research Unit of Internal Medicine, Università Campus Bio-Medico di Roma, Rome, Italy., Finamore P; Department of Thoracic Surgery, Università Campus Bio-Medico di Roma, Rome, Italy., Longo F; Department of Thoracic Surgery, Università Campus Bio-Medico di Roma, Rome, Italy., Zompanti A; Department of Engineering, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico di Roma, Rome, Italy., Grasso S; Department of Science and Technology for Sustainable Development and One Health, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico di Roma, Rome, Italy., Solomon SB; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York., Vincent A; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., McKnight A; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Cirelli M; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Voli C; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Kelly S; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Merone M; Department of Engineering, Unit of Computational Systems and Bioinformatics, Università Campus Bio-Medico di Roma, Rome, Italy., Molena D; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Gray K; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Huang J; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Rusch VW; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Bains MS; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Downey RJ; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Adusumilli PS; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Jones DR; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York.
Jazyk:	angličtina
Zdroj:	Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer [J Thorac Oncol] 2024 Sep; Vol. 19 (9), pp. 1272-1283. Date of Electronic Publication: 2024 May 16.
DOI:	10.1016/j.jtho.2024.05.006
Abstrakt:	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. Competing Interests: Disclosure Dr. Rocco has a financial relationship with Scanlan, Merck, and Medtronic. Dr. Prasad S. Adusumilli serves as consultant for ATARA Biotherapeutics, Bayer, Carisma Therapeutics, Imugene, ImmPactBio, and Johnson & Johnson. Dr. Park has received honoraria from Intuitive Surgical, AstraZeneca, and Medtronic, serves as a consultant to Ceevra, and has received institutional research support from Intuitive Surgical. Dr. Bott is a consultant for AstraZeneca Pharmaceuticals, Iovance Biotherapeutics, and Intuitive Surgical and receives research support from Obsidian Therapeutics. Dr. Molena serves on a steering committee for AstraZeneca and as a consultant for Johnson & Johnson, Bristol-Myers Squibb, AstraZeneca, and Boston Scientific, and has been an invited speaker for Merck and Genentech. Dr. Isbell has served as an advisory board member for AstraZeneca and Merck and as an uncompensated steering board member for Genentech, has received institutional research support from ArcherDx/Invitae, Guardant Health, GRAIL, and Intuitive Surgical and travel support from Intuitive Surgical, and has equity or ownership interest in LumaCyte. Dr. Rusch receives grant support (institutional) from Genelux and Genentech, travel support from Intuitive Surgical, and travel support and payments from the National Institutes of Health/Coordinating Center for Clinical Trials. Dr. Solomon serves as a consultant for GE Healthcare and Merck and on the data monitoring committee for Candel Therapeutics and Impact Biotech. Dr. Jones is a member of the Advisory Council for AstraZeneca and Advisory Committee for More Health, has been a speaker for DAVA Oncology, and receives research grant support from Merck. The remaining authors declare no conflict of interest. (Copyright © 2024 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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