Dr Gokula K. RAMACHANDRAN Cancer Science Institute Singapore Link to biosketch

Abstract

According to Globocan 2020, gastric cancer ranks fifth in incidence (1.1 million) and fourth in mortality (0.77 million deaths) worldwide. Given high global incidence rate, early diagnosis of gastric cancer appears to improve survival rates. The gold standard for the diagnosis of gastric cancer is esophagogastroduodenoscopy (EGD). However, this is expensive and invasive; hence it is not a cost-effective procedure as a screening tool for most countries. A good screening tool should be compatible to do mass screening leading to the reduction in the number of people needing EGD for confirmation and also to catch gastric cancer at an early stage. One promising non-invasive way of screening gastric cancer is by identifying volatile organic compound (VOC) biomarkers for gastric cancer in exhaled breath. The VOCs released by the cells are dissolved in the blood. These VOCs are carried to the alveoli via blood flow and excreted out during exhalation. Breath biomarkers for gastric cancer can be identified by comparing the volatile organic compounds VOCs in the exhaled breath obtained from gastric cancer patients and non- gastric cancer subjects, using gas chromatography and mass spectrometry (GC-MS). Our clinical study with 100 subjects is promising where we successfully employed the patented custom-made reusable end-tidal breath collection tube for breath collection and used gas chromatography mass spectrometry (GCMS) for breath analysis. Even though GCMS is very sensitive, they cannot be used in point of care as it is expensive, bulky and time consuming. So, to bring breath diagnostics to the point of care we developed a novel gas sensing technology which is highly customisable, affordable, portable and real-time. The ¹³C urea breath test is already a popular, widely-used, non-invasive rapid diagnostic procedure for screening H. pylori infection in the human stomach. Our objective is to realise a point of care non-invasive breath test for gastric cancer screening.