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Tumor Discovery Volatile organic compounds for cancer screening

new technique with a wide range of clinical applications Metabolic changes associated with the pathophysiology
(Table 1). VOCs are by-products of biochemical of several diseases and malignancies have been shown to
1-7
reactions and are defined as carbon-containing compounds trigger shifts in the VOCs produced by the human body. 1-5
detectable as a gas at room temperature. Endogenous Recent efforts have focused on the identification of
1
VOCs are generated within the human body as by-products VOCs as disease biomarkers. The hallmarks of tumor
of metabolic biochemical pathways. Once produced, biology and the neoplastic process include sustained
1-6
the VOCs diffuse into bodily fluids, tissues, and systemic proliferative signaling, uninhibited growth, angiogenesis,
circulation. Consequently, they can be detected in the and reprogrammed energy metabolism, leading to
1-3
bloodstream and transported by the circulatory system. invasion and metastasis. Hypoxia, hyperproliferation,
6
Some VOCs are released in exhaled breath, while others inflammation, and reactive oxygen species result in
are secreted in urine and feces. 1,3-6 In contrast, exogenous marked shifts in both the range and concentration of
VOCs are introduced into the body, including smoking, detectable VOCs. 1,5,6 These neoplastic processes cause
dietary intake, medications, and cytotoxic treatments. measurable, distinct, and immediate changes to the human
2
Table 1. Emerging applications for VOC analysis

Application Description
Environmental • Health risk assessment and personal exposures to environmental VOCs
exposures 117-119 • Exposure to cigarette smoke, tobacco, VOCs from e-cigarettes
• Workplace exposures to hazardous VOCs, fumes, smoke, and inhaled particles
• Environmental risk assessment of toxicity exposure
Oncology 9,120 • Potential applications as a screening tool for several malignancies, including colon, lung, breast, ovarian, prostate,
hepatobiliary, genitourinary, head and neck, cutaneous, and gastric cancers
• Can be used to estimate the burden of disease
• Monitor response to treatment
• Surveillance testing for disease recurrence
• Represents an innovative, accessible, inexpensive, and non-invasive diagnostic point-of-care tool
Benign disease 121-126 • Non-invasive diagnosis of inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
• Detection and clinical monitoring of benign respiratory conditions, including asthma, pulmonary hypertension, and chronic
obstructive pulmonary disease (COPD).
• Detection and monitoring severity of chronic kidney and liver disease
• Diagnosis of Parkinson’s disease and multiple sclerosis
• Monitoring glycemic controls and sequela of diabetes mellitus
Perioperative • Prediction and early detection of anastomotic leaks in esophageal, pancreatic, and colorectal surgery
medicine 126-131 • Diagnosis of post-operative pneumonia
• Predicting paralytic ileus
• Intraoperative monitoring, analysis of anesthetic and sedation
• Diagnosis and monitoring of sepsis
• Response to nutritional interventions
Drug testing 134,135 • Detection of marijuana metabolites in urine and in exhaled breath
• Detection of impact and extent of use of tobacco products, monitor response to smoking cessation
• Detection of alcohol consumption
• Detection of illicit drug biomarkers in exhaled breath
• Assessing compliance with medical treatments
• Assessing absorption and metabolism of medical treatments as well as surveillance of adverse effects
Transplant 132,133,136-138 • Analysis of VOCs for early detection and prediction of transplant rejection
• Applications in lung and hepatobiliary transplant
• Diagnosis of lung allograft dysfunction
• Detection of exhaled ammonia for early diagnosis of hepatic encephalopathy and monitoring response to treatment
• Diagnosis of graft-versus-host disease
• Detection of post-transplant acute kidney injury and monitoring response to hemodialysis
Infections 21-23 • Monitoring respiratory infections in at-risk populations, i.e., immunosuppression, post-transplant, cystic fibrosis, and pediatrics
• Differentiation between viral and bacterial respiratory infections in cystic fibrosis and COPD
• Diagnosis of human echinococcosis, an infectious disease caused by helminths
• Diagnosis of tuberculosis and response to treatment
• Diagnosis of pneumonia and response to treatment, i.e., Pseudomonas and Aspergillosis
Abbreviation: VOC: Volatile organic compound.

Volume 3 Issue 2 (2024) 2 doi: 10.36922/td.2061