HER2 Support Group Forums - Good article on personalized treatment..

And closer!

http://www.medicalnewstoday.com/medi...p?newsid=68165

Targeting treatment directly to the tumor cells, sparing healthy cells the worst of chemotherapy's damage. A push in oncology toward protecting patients against drugs and treatments, although successful for some patients, won't work for most others.

However, the tactic of using biopsied cells to predict which cancer treatments can work best for the patient, by taking pieces of "fresh" tumor tissue, apply different chemotherapy treatments to it and examine the results to see which drug or combination of drugs do the best job killing the tumor cells.

Older technology assays failed because scientists looked to see which drugs inhibited the cancer cells' growth (cell-growth), not which chemotherapies actively killed the tumor cells (cell-death). Cancer wasn't growing faster than other cells, it was just dying slower. The newer assay technology connects drugs to patients by what "kills" their cells, not by what "slows" them down.

The functional profiling technique is a cell-death endpoint assay system in which drug effect upon cancer cells is visualized directly. Photomicrographs of actual tumor cells show the condition of the cells as they are received and enriched in the lab, and also the condition of control cells post-culture.

This discriminates tumor from nontumor cells. The entire contents of each microliter plate well of tumor cells, including controls and each drug at each concentration, are spun onto glass slides, stained cytologically, and retained as a permanent archival record.

In this visualization, the microscopic slides sometime show that the exact same identical individual culture well, shows some clusters have taken up vast amounts of the drug, while right next door, clusters of the same size, same appearance, same everything haven't taken up any of the drug.

So it doesn't matter if there is a "target" molecule (protein or receptor) in the cell that the targeted drug is going after, if the drug either won't "get in" in the first place or if it gets pumped out/extruded or if it gets immediately metabolized inside the cell, drug resistance is multifactorial. The advantage of functional profiling is that it can show this in the "population" of cells.

Functional profiling uses a variety of metabolic and apoptotic measurements to determine if a specific drug was successful at killing the patient's cancer cells. The method differs from other tests in that it assesses the activity of a drug upon combined effect of all cellular processes, using combined metabolic (cell metabolism) and morphologic (structure) endpoints, at the cell "population" level, measuring the interaction of the entire genome.

Other tests, such as those which identify DNA, RNA sequences, or expression of individual proteins often examine only one component of a much larger, interactive process. Functional profiling measures genes before and after drug exposure. Gene expression profiles measures the gene expression only in the "resting" state, prior to drug exposure.

The functional profiling method makes the statistically significant association between prospectively reported test results and patient survival. It can correlate test results which are obtained in the lab and reported to physicians prior to patient treatment, with significantly longer or shorter overall patient survival depending upon whether the drug was found to be effective or ineffective at killing the patient's tumor cells in the laboratory.

This could help solve the problem of knowing which patients can tolerate costly, new treatments and their harmful side-effects. These "smart" drugs do not work for everyone, and a test to determine the efficacy of these drugs in a patient could be the first crucial step in personalizing treatment to the individual.

CytoRx™ Standard Drugs Profile

http://weisenthalcancer.com/Patient%...Rxpatients.htm

EGFRx™ Targeted Therapy Profile

http://weisenthalcancer.com/Patient%...RXPatients.htm