Volatile organic compound analysis for the diagnosis of pancreatic cancer

: As pancreatic cancer lacks any characteristic clinical symptoms within its early stages, the development of new diagnostic tools is essential in improving outcomes. The analysis of volatile organic compounds (VOCs) produced by pancreatic cancer cells and/or the tumour microenvironment is one such tool. Cancer-related alterations in cell metabolism result in marked shifts in the spectra and concentrations of the VOCs produced. These changes are specific to each cancer and, as such, the last few decades have seen extensive efforts to develop VOC biomarkers, by identifying key differences between healthy controls and individuals with cancer. Being non-invasive in nature and cheaper than other investigation techniques, VOC analysis is certainly an attractive method. A pooled analysis of all the current literature related to pancreatic cancer, highlights the significant potential of the technique: sensitivities of 87.67%, 85.00% and 83.30% as well as specificities of 87.00%, 81.00% and 81.90% have all been shown for breath, urine and bile respectively. However, before being utilised clinically, certain challenges, such as standardisation of methodology, must be addressed. This review, critically examines the progress made in the development of VOC analysis, as a diagnostic tool in early pancreatic cancer, and will also highlight the current challenges and limitations that exist.