1 Medical and Preventive Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
2 School of Medical Oncology, University of Udine, Udine, Italy.
Int J Biol Markers. 2019 Jun;34(2):205-209. doi: 10.1177/1724600818817316. Epub 2019 Mar 11.
The purpose of this case report is to describe the potential that metabolomics breath analysis may have in cancer disease monitoring. The advances in mass spectrometry instrumentation allow the accurate real-time analysis of volatile metabolites exhaled in the breath. The application of such non-invasive devices may provide innovative and complementary monitoring of the physio-pathological conditions of cancer patients.
A 59-year-old Caucasian woman with spindle cell malignant mesenchymal sarcoma of the presacral region started a first-line therapy with non-pegylated liposomal doxorubicin and ifosfamide associated with pelvic radiant treatment. After two cycles of chemotherapy plus radiotherapy, a significant pulmonary disease progression was reported. Thus, a second-line therapy with trabectedin was administered. However, after only two cycles of treatment a re-staging computed tomography scan reported further cancer disease progression of the target pulmonary lesions as well as occurrence of new satellite bilateral nodules. Real-time analysis of breath exhaled volatile organic compounds, performed by select ion flow tube mass spectrometry (SIFT-MS) during the follow-up of the patient, showed a specific metabolic pattern not observed in the breath of other soft tissue sarcoma patients who achieved clinical benefit from the treatments.
This case report revealed the importance of the non-invasive real-time volatile organic compounds breath analysis to distinguish individual specific chemo-resistance phenotypes among soft tissue sarcoma patients. Such observation seems to suggest that breath metabolomics may be particularly useful for monitoring cancer disease progression in soft tissue sarcoma patients where only cost-effective diagnostic tools, such as positron emission tomography and computed tomography, are available.
本病例报告旨在描述代谢组学呼气分析在癌症疾病监测中的潜在应用。质谱仪器的进步使得对呼吸中挥发代谢物的准确实时分析成为可能。这种非侵入性设备的应用可能为癌症患者的生理病理状况提供创新和补充监测。
一名 59 岁白人女性，患有原发性骶前区梭形细胞恶性间叶肉瘤，开始一线治疗，方案为非聚乙二醇化脂质体阿霉素联合异环磷酰胺，并联合盆腔放射治疗。两个周期的化疗加放疗后，报告肺部疾病显著进展。因此，给予二线治疗药物替泊替尼。然而，仅两个周期的治疗后，再次进行计算机断层扫描分期报告显示目标肺病变的癌症疾病进一步进展，以及双侧新卫星结节的发生。在对患者进行随访期间，通过选择离子流管质谱（SIFT-MS）进行的呼气挥发有机化合物实时分析显示出一种特定的代谢模式，在其他从治疗中获得临床获益的软组织肉瘤患者的呼吸中未观察到这种模式。
本病例报告揭示了非侵入性实时挥发有机化合物呼吸分析在区分软组织肉瘤患者个体特定化疗耐药表型中的重要性。这种观察似乎表明，呼吸代谢组学可能特别有助于监测软组织肉瘤患者的癌症疾病进展，因为仅有的具有成本效益的诊断工具，如正电子发射断层扫描和计算机断层扫描，在这种情况下可用。
