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Project Co-Leads: Drs. Geoffrey Liu and Chung-Wai Chow

Vision: Harnessing information from a patient’s breath sample to detect lung cancer early.

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Main Hypothesis:

Breath biomarkers, similar to blood-based biomarkers, will be used as a non-invasive way to improve the early detection of lung cancer.


Dogs can be trained to smell lung cancer on patients’ breath with relatively high accuracy. This method, however, is infeasible for regular clinical use, due to maintenance costs and lengthy training times. Despite this, “smelling” cancer on the breath may still be a feasible approach for improving the early detection of lung cancer.


The “smell” is actually the detection of volatile organic compounds (VOCs) released by cancer cells. Breathomics is the study of the detection of VOCs in the human breath. Breath analysis can be used as a clinical research tool and to explain specific physiological mechanisms. New “electronic noses” have recently been developed to detect these VOCs in exhaled breath. The team believes that screening with this technology could help differentiate malignant from benign masses in CT scans.


They plan to evaluate the potential of one particular “electronic nose” device, called SpiroNose, to detect lung cancer early. We will be testing individuals in lung cancer screening programs (heavy smokers), lung cancer clinics at Princess Margaret Cancer Centre (any smoking status), as well as their loved ones (who can act as healthy controls; also any smoking status).


What will the impact be in five years? 

We believe this new screening method will reduce the number of false-positives, ultimately reducing the overall number, cost, and potential harm of unnecessary CT scans and follow-up procedures. The SpiroNose is substantially more accessible and easily transportable than a CT scanner, as it is much smaller in size.


This kind of technology requires neither extensive training nor specialized facilities, and is not prohibitively expensive. Data is generated instantly and does not rely on sample storage, transportation, and handling. Theoretically, a central group can analyze patient results acquired from any location in real-time, as data generated by this technology is automatically uploaded to a secure server. 


Ultimately, we hope to use breath analysis to identify lung cancer early in both smokers and never-smokers. At the five-year mark, we would ideally like to be leading large scale trials across North America.

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