ChemoFit is a new laboratory test that helps identify the best chemotherapy for a patient's unique tumor thereby customizing their treatment. This equates to 'Individualized' chemotherapy based on the specific patient's own tumor characteristics.
ChemoFit - What is it?
ChemoFit is a specialized chemosensitivity/chemoresistance assay (CS/CR Assay). CS/CR assays use a patient's own tumor cells in the laboratory to identify which drugs have the most as well as the least potential for treating the patient's unique cancer. This information can increase the success of chemotherapy and reduce unnecessary toxicity.
CS/CR assays are being used by many cancer centers to guide treatment. CS/CR assays are used routinely in selecting chemotherapy for ovarian, lung, breast, colon, prostate, cervical cancers as well as sarcomas.
Different assays use different methods to get results. ChemoFit uses one of the most advanced technologies which is over 99% accurate for identifying resistant drugs and 87% accurate for identifying effective drugs.
What are the benefits of using ChemoFit to guide chemotherapy?
Oncologists presently choose chemo regimens based on clinical experience and general research data, combined with the patient's medical condition. This approach does not take into account that every patient's tumor is unique in the way it grows, and responds to treatment. ChemoFit will allow your oncologist to eliminate the regimens that are least likely to work and concentrate on the ones that have the most potential for killing your unique tumor.
Current studies show that cancer patients administered chemotherapy after laboratory tests like ChemoFit respond more favorably to the treatment (see below). Studies are also showing a better survival for patients treated with drugs identified as the most effective by the tests.
Who should consider ChemoFit?
ChemoFit is recommended to guide chemotherapy for solid tumors like ovarian, lung, breast, colon, prostate, cervical, endometrial, pancreatic cancers and sarcomas. ChemoFit can be used for selecting both first line and second line chemotherapy, whether the aim of chemotherapy is cure, or palliation.
Moreover, AccuTheranostics may now be used for the analyses of fluids/effusates.
What if my oncologist says ChemoFit™ is not necessary?
ChemoFit™ is the latest in a new generation of tumor assays. Albeit, tumor assays have been around for more than two decades, until recently, their accuracy has been less than ideal. Your oncologist may be basing their opinion on the older generation of tests and as such your oncologist may not yet be familiar with the advantages of using this newer generation test.
Rapid advances in technology now allow tumor behavior in the lab to accurately predict tumor behavior in your body. Newer tests are measuring true indicators of tumor response to chemo like cancer cell death (while older tests measured reduction in tumor growth). More and more studies are emerging where test-guided chemotherapy is shown to improve treatment outcomes including survival.
With most cancers, there are many choices of chemo regimens. The oncologist typically chooses regimen based on an educated guess (called "empiric therapy"). The treatment of cancer is now moving away from empiric therapy to individualized treatment. A new generation of tests, like ChemoFit™, is starting to change the way chemotherapy is chosen. As with all innovations, it will take time for ChemoFit™ to gain widespread acceptance among oncologists.
How can I get ChemoFit™?
Cancer patients should contact their respective oncologist to discuss their individual medical history, and suitability for the test. Alternatively, you may contact your AccuTheranostics representative at firstname.lastname@example.org or call 877-402-2623.
ChemoFit™ requires a fresh tumor sample and the patient must be off any chemotherapy treatment for two weeks prior to the test. Patients who are not candidates for surgery or who have already had surgery often can have a small office-based procedure performed to obtain a tumor sample for the ChemoFit™ test.
Is there any data supporting the use tumor assays?
Data supporting the use of tumor assays is emerging steadily and is very encouraging. Studies show that cancer patients administered chemotherapy after in vitro evaluation, respond more favorably to the treatment with resultant decreased toxicity.
Cortazar P, Johnson, B.E., Review of the Efficacy of Individualized Chemotherapy Selected by in-vitro
Drug Sensitivity Testing for Patients With Cancer, Journal of Clinical Oncology, 17(15):1625-31, May 1999
Strauss E., Pre-testing Tumors, Scientific American, 280(2):19,22, Feb 1999
Simonsen, M., Growth is Forecast for Tumor Markers, Oncogene Assay Market, American Health Consultants, 1(4):1-6, 1998
Meta-analysis studies further indicate that there is a more favorable response in patients treated with regimens based on in-vitro assay results.
Cortazar, A., Johnson, M., Meta-analysis Studies in Patients Treated With Regimens Based on in-vitro Assay Results Than Those That Are Not, Journal of Clinical Oncology, 1999
SA Bradford, DL Marchette, AP Prezyna, CP Karakousis. Determining Breast, Melanoma and Ovarian Solid Tumor In Vitro Chemoresistance/Sensitivity While Simultaneously Characterizing The Tumor's BioMorphoMolecular Marker (BMMM) Profile. A Preliminary Study. Accepted J Med. Sept, 2005.
Bradford, S. Preclinical in vitro tumor sensitivity may be associated with surrogate markers as a clinical predictor of chemotherapy in patients with ovarian carcinoma. Cancer Epidemiology Biomarkers and Prevention, 11(10) Abstract # C134, pg 1200, 2002
Invited Speaker: Bradford, Sherry, A. The use of Bio-active Markers to Compile a 'Bio-score' on which to Base a Chemoregimen in Patients with Ovarian Cancer. Traditional Cancer Therapy and Beyond in the New Millennium. Presented: Proceedings of the 6th Int'l Conf on Frontiers of Polymers and Adv Materials, Recife, Brazil, March, 2001.
JM Hyatt, SA Mangione (Bradford), JJ Schentag. PD Modelling of Three Chemotherapeutic Agents and Human Lung Tumor Cells. Presented: Am Soc for Clin Pharm and Thera, San Antonio, TX, March, 1999. (Am Soc for Clin Pharm and Thera, 65: PIII-87, 1999.
JM Hyatt, SA Mangione (Bradford), JJ Schentag. Determination of Phenotypic Susceptibility of Chemotherapy. Presented: 21st Int'l Congress of Chemotherapy, Birmingham, England, UK, July 8, 1999.
JM Hyatt, SA Mangione (Bradford), JJ Schentag. A Chemosensitivity Assay Bases on Pharmacodynamic Modelling of the Effect of Chemotherapeutic Agents on Human Ovarian Tumor Cells. Presented: 21st Int'l Congress of Chemotherapy, Birmingham, England, UK, July 8, 1999.
In addition, patient survival has been shown to correlate with administering assay-guided therapy.
Mehta, R. et al., Breast Cancer Survival and in vitro Tumor Response in the Extreme Drug Resistance Assay, Breast Cancer Research and Treatment, 66:225-237, 2001
Loizzi, V., et al., Survival Outcomes in Patients With Recurrent Ovarian Cancer Who Were Treated With
Chemoresistance Assay Guided Therapy, American Journal of Obstetrics and Gynecology, 89(5):1301-7, 2003
What makes ChemoFit the ideal tumor assay?
- Results are available within 72 hours.
- Tumor cells are exposed to drug concentrations that are physiologically achievable.
- Tumor cells are exposed to single drugs as well as combinations of drugs.
- On-protocol drugs, off-protocol drugs, novel drugs "in the pipeline" and "orphan" drugs can be evaluated.
- Cell growth inhibition is not evaluated (due to inaccuracies of this method).
- The end point is cell death, regardless of pathway (apoptosis alone as an end-point is not a sufficient indicator of cell-death).
- All causes of cell death are measured (drugs that target cell cycle parameters, signal transduction pathways, angiogenesis inhibition etc. can be evaluated).
- No pathological interpretation is required (interpretation is subjective).
- The cells analyzed are non-clonogenic, giving a better representation of the heterogenic cell mass within the tumor (yielding a better indication of the chemotherapeutic response).