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May 24/31, 2000

Chemotherapy Breath Test

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JAMA. 2000;283(20):2646. doi:10.1001/jama.283.20.2646-JQU00003-4-1

A relatively simple breath test could prove to be lifesaving for some patients who receive cancer chemotherapy.

The test offers a new method of determining how rapidly patients metabolize docetaxel. In a study of 21 patients with cancer, researchers at the University of North Carolina at Chapel Hill first used several blood tests in a 24-hour period to determine how quickly the patients' livers cleared docetaxel. They then compared those findings with results from a breath test in which the researchers gave the patients a trace dose of erythromycin and measured the amount of carbon dioxide they exhaled. Rapid metabolizers of erythromycin exhale higher concentrations of carbon dioxide, and slow metabolizers exhale smaller amounts.

Because the same enzyme system in the liver clears erythromycin and docetaxel, the researchers wanted to determine if the breath test could also distinguish between rapid and slow docetaxel metabolism. They found that the two patients who became very ill and were hospitalized after taking the cancer drug also had the lowest exhaled carbon dioxide amounts after receiving erythromycin. The findings appeared in the April issue of Clinical Cancer Research.

Study author Paul Watkins, MD, noted that all recommended chemotherapy dosages make about 10% of patients very ill and can be fatal in up to 2% of patients. Additional studies have been launched to confirm the results.