Surreal illustration of exhaled nitric oxide and healthy lungs, representing lung cancer treatment success.

Can Your Breath Predict Lung Cancer Treatment Success? The Role of Nitric Oxide

Mira Elwood in Health & Wellness June 2025 • 5 min read.

"A new look at an old friend: How measuring exhaled nitric oxide could help personalize lung cancer therapy and track treatment response."

Lung cancer remains a formidable challenge, being the leading cause of cancer-related deaths worldwide. While treatments have advanced, predicting how a patient will respond to therapy remains a critical area of research. Recent studies have begun to investigate the potential of exhaled nitric oxide (NO) as a biomarker, offering a non-invasive way to monitor inflammation and treatment response in lung cancer patients.

Nitric oxide, a molecule naturally produced in the body, plays a crucial role in various biological processes, including inflammation. In the context of lung cancer, NO levels can indicate the degree of airway inflammation and oxidative stress, both of which are influenced by the tumor itself and the body's response to treatment. Researchers have been exploring whether changes in exhaled NO levels can serve as an early indicator of treatment effectiveness and disease progression.

This article will delve into the findings of a study that examined the relationship between exhaled NO levels and chemotherapy response in lung cancer patients. By understanding how NO levels change during treatment, we can gain valuable insights into the inflammatory processes associated with the disease and potentially personalize treatment strategies for better outcomes. This approach offers a promising avenue for improving lung cancer management and patient care.

Nitric Oxide: A Window into Lung Cancer Treatment Response

Surreal illustration of exhaled nitric oxide and healthy lungs, representing lung cancer treatment success.

A recent study investigated how exhaled nitric oxide (NO) levels change in lung cancer patients undergoing chemotherapy. The study involved 42 patients diagnosed with early-stage lung cancer. Researchers measured NO levels in their exhaled breath before and after three cycles of chemotherapy, while also monitoring inflammatory markers and lung function.

The study revealed a significant decrease in exhaled NO levels after three cycles of chemotherapy across all patients, irrespective of their cancer's histological type or stage. Specifically, the average NO level decreased from 9.8 to 7.7 after the chemotherapy cycles. This finding suggests that chemotherapy effectively reduces airway inflammation in lung cancer patients. The researchers also found strong correlations:

NO Levels and C-Reactive Protein (CRP): A direct relationship was observed between NO levels and CRP, a key marker of inflammation, both before and after chemotherapy.
NO Levels and Monocytes: A notable correlation was found between exhaled NO levels and monocyte counts (P < 0.003, r = 0.49), a type of white blood cell involved in inflammatory responses, regardless of whether it was before or after chemotherapy.

These correlations highlight the role of NO as an indicator of inflammatory processes in lung cancer. The decrease in NO levels alongside reductions in CRP and monocyte counts suggests that chemotherapy not only targets cancer cells but also modulates the inflammatory environment within the lungs. This modulation could be a crucial factor in determining treatment success.

The Future of Lung Cancer Treatment: Personalized Approaches

The study underscores the potential of exhaled NO as a valuable tool for monitoring treatment response and personalizing lung cancer therapy. By tracking changes in NO levels, clinicians may be able to:

<ul> <li>Assess Treatment Effectiveness: Early reductions in NO levels could indicate a positive response to chemotherapy, allowing for timely adjustments to treatment plans if needed.</li> <li>Identify Inflammatory Responses: Monitoring NO levels can help identify patients with heightened airway inflammation, enabling targeted interventions to manage this aspect of the disease.</li> <li>Personalize Treatment Strategies: NO measurements could contribute to a more individualized approach to lung cancer treatment, tailoring therapies based on a patient's specific inflammatory profile.</li> </ul>

While further research is needed to validate these findings and explore the full potential of NO as a biomarker, this study offers a promising glimpse into the future of lung cancer management. Non-invasive monitoring of exhaled NO could pave the way for more effective and personalized treatment strategies, ultimately improving outcomes for patients with this challenging disease.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/ott.s44087, Alternate LINK

Title: Measurement Of Exhaled Alveolar Nitrogen Oxide In Patients With Lung Cancer: A Friend From The Past Still Precious Today

Subject: Pharmacology (medical)

Journal: OncoTargets and Therapy

Publisher: Informa UK Limited

Authors: Paul Zarogoulidis, Anastasios Kallianos, Aggeliki Rapti, Spyratos, Darwiche, Wolfgang Hohenforst-Schmidt, Georgia Trakada, Konstantinos Porpodis, Tsioulis, Charpidou, Konstantinos Zarogoulidis, Kosmas Tsakiridis, Karapanzos, Tsimpoukis, Panoutsopoulos, Lemonia Veletza, Kostopoulos, Kostas Kostopoulos, Konstantinos Syrigos

Published: 2013-05-01

Everything You Need To Know

What exactly is exhaled Nitric Oxide (NO), and how does it relate to lung cancer?

Exhaled Nitric Oxide (NO) is a molecule naturally produced in the body and is measured in the breath. It's a biomarker that indicates the level of inflammation and oxidative stress in the lungs, which are affected by lung cancer and its treatments. In the context of lung cancer, monitoring NO levels offers a non-invasive way to assess how the body is responding to treatment and how the disease is progressing. It helps clinicians understand the inflammatory processes associated with lung cancer and tailor treatment strategies.

Why is Nitric Oxide (NO) important in the context of lung cancer treatment?

Nitric Oxide (NO) is significant in lung cancer treatment because its levels in exhaled breath can serve as an early indicator of how a patient is responding to chemotherapy. Studies show that as the treatment works, NO levels decrease. This decrease is linked to a reduction in inflammation within the lungs. This information allows doctors to personalize treatment plans, which could lead to better outcomes for patients. Monitoring NO levels also offers a way to assess the effectiveness of treatments in real time, allowing for timely adjustments.

What did the study reveal about Nitric Oxide (NO) levels during chemotherapy?

The study found that after three cycles of chemotherapy, the average Exhaled Nitric Oxide (NO) levels decreased. This reduction suggests that the chemotherapy was effectively reducing airway inflammation in lung cancer patients. This is important because it indicates that chemotherapy not only targets cancer cells but also influences the inflammatory environment within the lungs. There were also correlations found between NO levels and other inflammatory markers like C-Reactive Protein (CRP) and monocyte counts, which further supports the role of NO as an indicator of inflammatory processes.

What is the significance of C-Reactive Protein (CRP) in relation to Nitric Oxide (NO) levels?

C-Reactive Protein (CRP) is a key marker of inflammation in the body. The study showed a direct relationship between exhaled Nitric Oxide (NO) levels and CRP levels, both before and after chemotherapy. This correlation highlights that as inflammation changes in the lungs, reflected by CRP levels, the NO levels also change in parallel. This makes NO a useful tool for monitoring treatment response by tracking changes in inflammation.

How could monitoring Nitric Oxide (NO) levels potentially change the way lung cancer treatment is done?

By tracking changes in Exhaled Nitric Oxide (NO) levels, clinicians could potentially personalize lung cancer therapy. They may be able to gauge the effectiveness of a treatment and make adjustments as needed. This could lead to more effective treatment strategies tailored to the individual patient's response, potentially improving outcomes and patient care. This personalized approach moves away from one-size-fits-all treatments towards strategies that are adjusted based on the patient's specific biological response, as indicated by their NO levels.