INHALE: Investigating Novel Host Alterations via Labelled volatilEs

• Research type

  Research Study

• Full title

  Investigating Novel Host Alterations via Labelled volatilEs

• IRAS ID

  359253

• Contact name

  George Hanna

• Contact email

  hod.surgery.cancer@imperial.ac.uk

• Sponsor organisation

  Imperial College London

• Duration of Study in the UK

  3 years, 0 months, 30 days

• Research summary

  
  Oesophago-gastric cancer (OGC) is the fifth most common cancer in the UK, with around 13,000 new diagnoses each year. Sadly, only 1 in 10 people diagnosed with oesophageal cancer are expected to survive beyond 10 years.

  Patients with OGC release a distinct pattern of breath metabolites known as volatile organic compounds (VOCs), which differ from those in individuals without cancer. Breath analysis can detect OGC in approximately 80 out of 100 cases. This diagnostic accuracy can be improved by using a stimulant such as a specially formulated drink that amplifies the release of tumour-specific VOCs. This approach, known as ‘augmentation’, is a novel method to enhance OGC detection.
  VOCs in OGC are believed to arise from three compartments: the endoluminal compartment, systemic circulation, and the oral cavity. These are influenced by the tumour, tumour associated microbiome, and immune responses. To better target these VOCs, it is crucial to understand both their origin and the biological mechanisms behind their production. This knowledge may not only improve early detection but also identify new therapeutic targets.

  This single-centre study will recruit 60 adults with OGC over three years. It aims to refine breath testing by combining VOC augmentation with isotope labelling and mechanistic insights into microbiome involvement.

  Phase 1 will identify isotope-labelled VOCs produced by tumour-associated bacteria using mass spectrometry.
  Phase 2 will track these labelled compounds in OGC patients to determine their origin and production pathways.
  Phase 3, building on Phase 2, will assess the effect of targeted antibiotic therapy on VOC profiles.

  Patient and public involvement will inform breath test design to ensure it is practical, acceptable, and patient-centred.
  The ultimate aim is to develop a rapid, non-invasive diagnostic tool to support earlier detection of OGC in patients with non-specific symptoms, improving outcomes through timely intervention.

• REC name

  London - Surrey Research Ethics Committee

• REC reference

  26/LO/0216

• Date of REC Opinion

  20 Apr 2026

• REC opinion

  Further Information Favourable Opinion