Background

Malignant pleural mesothelioma (MPM) is an aggressive cancer with poor prognosis. Early diagnosis is believed to improve outcome, however, screening tools are lacking. A breath test showed promising to accurately differentiate asbestos-exposed (AEx) individuals from MPM patients.

Aim

Determining the clinical utility of a breath test as a screening tool for MPM through first external validation.

Methods

Individuals with occupational asbestos exposure were prospectively included for 4 annual breath tests to predict individual risk of MPM of the AEx participants using multicapillary column/ion mobility spectrometry (MCC/IMS). Correlation of breath test outcome with a CT scan will be done after each sampling round (Figure 1).

Results

In total, 112 AEx individuals and 6 MPM patients were included in the first of 4 screening rounds. 78 of the 112 AEx group were classified by the breath-based model as deviant, excluding ±30% of at-risk persons for further follow-up. Additionally, all 6 MPM patients were correctly classified (100% sensitivity and 100% NPV). Results of the second breath sampling round will be available for presentation at the ERS 2023 meeting.

Conclusions

The current research may lead to the initiation of a screening program for MPM in AEx individuals through exhaled breath, as all MPM patients were correctly classified and 30% of AEx individuals were excluded from further follow up.