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Metabolomic Profiling of Dried Blood Spots for Breast Cancer Detection: A Multi-Classifier Validation Study in 2,734 Participants

Preprint by Anctil, Hauguel, Rhéaume, Grobmyer, and Noel reporting a retrospective case-control classification study of 114 biopsy-confirmed breast cancer cases and 2,620 non-cancer controls, evaluated across six classifier families.

Why it matters

Reports disease-classification signal from BioTwin's same-lab dried blood spot LC-MS protocol in this retrospective case-control cohort, with batch-aware validation designed to reduce the optimistically biased estimates common in the field.

Summary

A cohort of 2,734 participants (114 biopsy-confirmed breast cancer cases and 2,620 non-cancer controls) was profiled by untargeted LC-MS/MS from a single dried blood spot (DBS), using a Thermo Scientific Orbitrap IQ-X coupled to a Vanquish UHPLC system. A pre-specified panel of 39 metabolites meeting MSI Level 1 identification criteria, selected on an independent prior workflow and applied here unchanged, was evaluated with six standard supervised-learning architectures (LASSO, Elastic Net, Linear SVM, PLS-DA, OPLS-DA, XGBoost). Detection performance was robust across classifier families, reaching an AUC of 0.928 for LASSO and 0.949 for XGBoost.

The paper addresses two recurring bottlenecks in blood-based cancer metabolomics: the field’s near-exclusive reliance on serum or plasma, which require venipuncture and cold-chain logistics, and machine-learning protocols that are blind to analytical batch structure and therefore report optimistically biased performance. DBS sampling removes the logistical barrier, and a batch-aware validation design keeps the reported estimates honest.

Why it matters

This is the disease-classification counterpart to BioTwin’s individual-identification work: the same minimally invasive, self-collected DBS matrix and the same single-laboratory LC-MS protocol, now applied to early breast cancer detection. Robustness across six independent classifier families, rather than a single tuned model, is what makes the signal credible.

Authors

Nicolas Anctil (1), Pierrick Hauguel (1), Caroline Rhéaume (2), Stephen Grobmyer (3), Louis-Philippe Noel (1). Corresponding author: Pierrick Hauguel (phauguel@biotwin.ai).

  1. Research and Development Department, BioTwin Inc., Quebec City, QC, Canada
  2. Université Laval, Quebec City, QC, Canada
  3. Oncology Institute, Fatima bint Mubarak Center, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates

Competing interests: Nicolas Anctil, Pierrick Hauguel and Louis-Philippe Noel are employees and shareholders of BioTwin Inc. Caroline Rhéaume and Stephen Grobmyer are external academic and clinical collaborators.