Detecting the Presence of Cancer in Patients’ Breath

When you think of diagnostic tests for cancer, the first that probably come to mind rely on using samples of blood or tissue. While these methods have their merits, interest is growing in a less-invasive alternative – breath. By analyzing the patterns of gaseous molecules called volatile organic compounds exhaled in breath, changes in metabolic activity associated with disease can be detected.

Thermo Fisher Scientific and Owlstone Medical have recently entered a collaboration, with the aim of advancing breath diagnostics for the early diagnosis of cancer and other diseases. Dr Max Allsworth, Chief Science Officer, Owlstone Medical, and Dominic Roberts, Product Marketing Manager, Orbitrap GC-MS, Thermo Fisher Scientific tell us more about the collaboration and the advantages that breath biopsies can bring to disease detection.

Q: Thermo Fisher Scientific have recently entered a collaborative partnership with Owlstone Medical. Can you tell us more about the agreement and the benefits it will bring?

A: Through the integration of leading Orbitrap gas chromatography mass spectrometry (GC-MS) instrumentation into Owlstone Medical’s Breath Biopsy platform, the collaboration will qualify Thermo Fisher’s mass analyzers for the detection of new biomarkers via a validated discovery and routine analysis project. Developed in partnership, the new analytical methods will be used to conduct metabolomics studies of breath samples for unique biomarkers that could translate into non-invasive, routine screening solutions for improved early diagnosis of cancer and other disease.

Q: How do you plan to integrate the Thermo Fisher Scientific technology into the Breath Biopsy platform?

A: Owlstone Medical’s Breath Biopsy platform consists of two components, breath collection through their unique ReCIVA® breath collection device which can be deployed absolutely anywhere, and sample processing, which is done in their Cambridge, UK laboratory. It is in this latter part of the process that the Thermo Scientific™ Q Exactive™ GC Hybrid Quadrupole-Orbitrap™ Mass Spectrometer is being incorporated. Owlstone Medical chose to partner with Thermo Fisher Scientific as the GC Orbitrap platform’s excellent sensitivity and specificity will enhance their ability to perform both targeted and untargeted analyses. The GC Orbitrap enables the confident identification of volatile compounds present in breath samples. The ultra-low and high concentrations encountered in these samples means that it’s essential the system is able to maintain performance at all levels. Once an initial validation project is completed, the technology will become a standard part of Owlstone Medical’s biomarker discovery process.

Q: Could you touch on the range of existing biopsy techniques? Are there any particular disadvantages associated with these that led to the development of a breath biopsy? What are the advantages of using breath biopsy for disease detection?

A: The classic form of biopsy is tissue biopsy, whereby a sample is surgically extracted from a patient. More recently liquid biopsy (blood) has emerged, generating a tremendous amount of interest through the potential to use circulating tumor DNA in blood as a marker of cancer and its progression. Breath by comparison is completely non-invasive and so is expected to drive patient compliance for testing, but more importantly is capable of whole body sampling in one minute (as in one minute all of the blood in the body passes through the lungs), and is capable of pre-enrichment. What that means is to look at very low levels of the chemicals all one needs to do is take a longer sample. This latter point along with the biological reality that metabolic changes often precede genetic changes in diseases, like cancer, mean that Breath Biopsy is uniquely well suited for early disease detection.

Q: Which diseases is the technology being developed to diagnose? Why were these chosen?

A: Because the volatile organic compounds (VOCs) detected through Breath Biopsy can come from anywhere in the body, or indeed from external sources, including gut microbiome, medications, diet and smoking status, the range of potential applications is incredibly broad. That said, areas of focus are oncology, liver disease, respiratory disease and environmental exposure.

Max Allsworth and Dominic Roberts were speaking to Anna MacDonald and Laura Lansdowne, Science Writers for Technology Networks.