Researchers are trying to determine if a breath test can detect malignant pleural mesothelioma in patients exposed to asbestos. Early results are promising, but more research is needed to see what can be done for patients. The study, which is known as MESOBREATH 5, uses a test to detect volatile organic compounds in exhaled breath. Early results from the study point to the test having a high sensitivity and negative predictive value but low accuracy, specificity, and positive predictive value. The study’s results were presented at the 2023 World Conference on Lung Cancer.
To be in the study, patients had to have a history of large occupational asbestos exposure with the first exposure being at least 30 years ago and have at least 15 fiber years. There was also a positive control group with patients who were already diagnosed with pleural mesothelioma. There were 121 patients with a history of asbestos exposure and seven patients with confirmed cases of pleural mesothelioma. All members of the asbestos exposure group were men while 71 percent of the confirmed mesothelioma group were men. Patients in the asbestos-exposed group had a higher mean body mass index and were overall younger. All patients underwent breath testing in 2022 and 2023. The sensitivity and negative predictive value of the breath test were both 100 percent. The positive predictive value was 4.2 percent, the accuracy was 29.1 percent, and the specificity was 26.9 percent.
Researchers decided to rule out false positives by giving the patients the test twice and to look at the patients only with two positive test results. Around 46 percent had two positive test results, which also includes the seven patients with confirmed mesothelioma cases. The next step in the study is to give low dose CT scans to patients with two positive test results to determine if they have mesothelioma. The researchers will also be looking for factors that could have influenced a positive breath test result when the patient did not have mesothelioma. Patients will continue to receive the breath test in 2024 and 2025 followed by more CT scans to confirm the presence or absence of mesothelioma.
