Out of the ivory tower: transitioning breathomics to clinical care

Extract The clinical applicability of breathomics profiling (the study of volatile organic compounds (VOCs) in exhaled breath) in the early diagnosis of lung cancer remains tantalisingly out of reach. The lack of validation of breath analysis in studies with large patient populations through multicentric collaboration has impeded the standardisation of this approach in clinical practice. Prof. Lamote and his group should be acknowledged for their painstakingly decisive contributions to the literature on breathomics during the last decade. The article by Zwijsen et al. [1] in this issue of ERJ Open Research is no exception to the customary rigorous analyses and excellent insights from this group on the differentiation, through analysis of exhaled breath, of benign and malignant solitary pulmonary nodules. The aim of their study was to substantiate – once again – the value of breath analysis in the selection of candidates for lung screening, with the obvious relevance to cost reduction and efficiency. Despite some hurdles in the application of breath analytic technology [2], the accuracy of breath analysis in predicting lung malignancy has unquestionably been established [3]. The validated experiences of several groups in the detection of lung cancer with electronic nose (E-nose) technology [4] consistently demonstrate the ability of both quantitative and qualitative exhalate analytic methods to achieve high accuracy.