Lung cancer causes more deaths in the US than the next three most common cancers combined (colon, breast, and pancreatic). Poor detection is a major factor underlying such a striking mortality rate.


Nir Peled, MD, PhD

A new noninvasive device developed by a team of Israeli, American, and British cancer researchers hopes to accurately detect lung cancer and identify its stage of progression. The breathalyzer test, embedded with a “NaNose” nanotech chip to literally “sniff out” cancer tumors, was developed by Nir Peled, MD, PhD, of Tel Aviv University’s Sackler Faculty of Medicine; inventor Hossam Haick, PhD, of the Technion–Israel Institute of Technology; and Fred Hirsch, MD, PhD, of the University of Colorado School of Medicine.

A study of the device, presented at a recent American Society of Clinical Oncology conference in Chicago, was conducted on 358 patients who were either diagnosed with or at risk for lung cancer. The participants enrolled at UC Denver, Tel Aviv University, University of Liverpool, and a Jacksonville, Florida, radiation center.

The Smell of Cancer

“Lung cancer is a devastating disease, responsible for almost 2,000 deaths in Israel annually—a third of all cancer-related deaths,” Peled said. “Lung cancer diagnoses require invasive procedures such as bronchoscopies, computer-guided biopsies, or surgery. Our new device combines several novel technologies with a new concept—using exhaled breath as a medium of diagnosing cancer.

“Our NaNose was able to detect lung cancer with 90% accuracy even when the lung nodule was tiny and hard to sample. It was even able to discriminate between subtypes of cancer, which was unexpected,” said Peled.

Lung cancer tumors produce chemicals called volatile organic compounds (VOCs), which easily evaporate into the air and produce a discernible scent profile. Haick harnessed nanotechnology to develop the highly sensitive NaNose chip, which detects the unique “signature” of VOCs in exhaled breath. In four out of five cases, the device differentiated between benign and malignant lung lesions and even different cancer subtypes.

The Bigger the Tumor . . .

“Cancer cells not only have a different and unique smell or signature, you can even discriminate between subtypes and advancement of the disease,” Peled said. “The bigger the tumor, the more robust the signature.”

The device and subsequent analysis accurately sorted healthy people from people with early-stage lung cancer 85% of the time, and healthy people from those with advanced lung cancer 82% of the time. The test also accurately distinguished between early and advanced lung cancer 79% of the time.

“The device could prove valuable in helping determine patients who need more intensive screening for lung cancer,” Peled said. “We’re hoping to have a device that would be able to give you a go/no-go result—something’s wrong, go get an x-ray.”

The Boston-based company Alpha Szenszor has licensed the technology and hopes to introduce it to the market within the next few years. Meanwhile, a new, smaller version of the device has since been developed that can plug into a computer’s USB port.

The study was supported by the European Union LCAOS grant, an EU-funded collaborative whose aim is to enable the earliest possible detection of lung cancer, and the International Association for the Study of Lung Cancer (IASLC).