An electronic nose could save thousands of lung cancer patients the brutal side effects of immunotherapy, scientists say.
A study of the device revealed that it could find out if patients with 85 had a negative reaction to the seminal drugs showing percent accuracy.
Patients inhale into the device, which then works with AI and only takes a minute to determine if the patient is likely to respond to immunotherapy or not.
Lung cancer kills 36,000 Britons a year and about 50,000 are diagnosed with the disease annually.
The negative side effects of immunotherapy may be beneficial for many lung cancer patients thanks to an electronic nose ( Figure), which determines whether patients respond poorly to the medication.
Affected individuals can be treated with immunotherapeutics that use the patient's own immune system to fight and destroy cancer cells.
While medications tend to have fewer side effects than chemotherapy, they can sometimes cause the immune system to attack healthy cells.
This can cause muscle aches, shortness of breath, headaches, diarrhea, and flu-like symptoms.  In very rare cases, the drugs cause the immune system to overdrive and attack vital organs.
Dutch researchers say the "eNose" can smell volatile organic compounds (VOCs), chemicals that make up about one percent of our exhaled breath.
By detecting how many different VOCs are present in the lungs, it can predict whether patients will respond to the drugs.
Immunotherapeutics attack a protein known as programmed death ligand 1 (PD-L1). However, they are only effective in 20 percent of patients.
The protein is thought to attenuate and weaken the immune system when non-small cell lung cancer – the most common lung cancer – occurs.
Immunohistochemistry is the only available test to predict who will benefit from the treatment, but doctors are needed to study the lung tissue to detect the protein.
Michel van den Heuvel, who led the research at Radboud University Medical Center, warned that it is invasive and takes too long to produce results.
The researchers thought that eNose technology could be a non-invasive and fast alternative to the current standard.
Researchers say the so-called eNose (shown) may be a protein known as programmed death ligand 1 (PD-L1) in the respiratory tract Patients smell
WHAT IS NON-SMALL CELL-LUNG CANCER?
Non-small cell lung cancer (NSCLC) is the most common form of the disease (80 percent of cases) and includes three specific types of tumors.
It includes adenocarcinomas, squamous cell carcinomas and other unspecified tumor types of NSCLC.
Adenocarcinoma is cancer that develops from mucus-producing cells in the airways.
This is the most common form of NSCLC and accounts for approximately 30 percent of all lung cancers.
Squamous cell carcinoma develops in the flat cells that line the airways.
Cancer not otherwise specified exists when physicians are not sure what type of lung cancer the patient has, but this is unusual.
Co-author Rianne de Vries, a graduate student at the Amsterdam University Clinics, added that physicians may be able to avoid treating patients with immunotherapy that they would not respond to.
& # 39; Using eNose, the patient takes deep breaths, holds them for five seconds, and then exhales slowly into the device.
& # 39; The eNose sensors respond to the complete mixture of VOCs in the exhaled breath; Each sensor has the highest sensitivity to another group of molecules.
& # 39; The sensor readings are sent directly to an online server and stored there to process the data in real time and to correct the ambient air, because the air you exhale is affected by the air you take breathe in.
& # 39; The measurement takes less than a minute, and the results are compared to an online database where machine learning algorithms immediately recognize whether the patient is likely to respond to anti-PD1 therapy or not
Between March 2016 and February 2018, researchers from the Netherlands Cancer Institute in Amsterdam recruited 143 patients with advanced lung cancer.
With eNose they recorded the respiratory profiles of the patients two weeks before starting treatment with the immunotherapeutic agents nivolumab or pembrolizumab.
After three months, they assessed whether patients responded to the treatment or not.
Co-author dr. Mirte Müller, a PhD candidate in the Department of Thoracic Oncology at the Dutch Cancer Institute, said, "We found that before starting treatment with immunotherapy, the eNose analysis of exhaled breath from patients with non-small cell lung cancer could be accurate to 85 Distinguish between responders and non-responders.
& # 39; Our results show that eNose breath analysis may potentially avoid the use of ineffective treatment in patients not considered effective by eNose – respondents to immunotherapy, which in our study was 24 percent of patients ,
"This means that in 24 percent of lung cancer patients, this treatment could be avoided without an effective treatment being denied."
Professor Charles Swanton, chief investigator at Cancer Research UK, said, "This small study adds to the growing evidence that the search for tell-tale signs of cancer in the breath could someday be useful for physicians seeking the best treatment decide their patients.
"Immunotherapy is already changing the way we treat some people with lung cancer, and this research helps us to understand who is more likely to benefit from it.
"More comprehensive studies are needed to understand the potential of this innovative technology, allowing researchers to compare the cost and effectiveness of eNose with existing immunotherapy response indicators."
The results were published in the cancer journal Annals of Oncology.
Is lung cancer routinely screened in the UK?
There is no national screening program for lung cancer in the UK.
Unlike cervical and mammary smear tests on breast tumors, lung cancer is not routinely studied.
NHS claims there is no screening for it It has been shown to save the lives of people with lung cancer.
Low-dose CT scans have been studied, but involve risks.
The lungs are reportedly very sensitive to radiation and frequent examinations can actually cause damage.
And screening can lead to overdiagnosis.
Some scan-acquired lung cancers never become life-threatening, according to NHS.
These patients may then receive unnecessary treatments that cause side effects and anxiety.
Currently looking for an accurate lung screening method.
One option is a spiral CT scan, which uses fewer rays than standard CT scans.
The National Lung Screening trial found that the number of patients at risk of lung cancer has decreased.
But there were also overdiagnoses.
Another option is fluorescence bronchoscopy, which examines the lining of the airways with blue and white light.
One study found that potentially carcinogenic changes may be addressed.
However, the NHS adds further research beforehand This approach may be considered for a lung screening program.
An ongoing study called Lung-SEARCH is investigating the efficacy of combining spiral CT scans with fluorescence bronchoscopy.
Another approach is to search for chemical changes in the body.
A study called MEDLUNG analyzes whether changes in cells in the mucus of high-risk patients may indicate cancer.
In the United States, the American Cancer Society recommends that current or former smokers at higher risk perform a low-dose CT scan once a year.