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Sarah,

Comprehensive molecular tumor profiling is offered by Caris Life Sciences, founded in 2005. To date, Caris has profiled the cancers of 20,000 patients.

Caris’ evidence-based molecular profiling test, Caris Target Now, is providing some compelling success stories, which you can watch in short videos produced by the company. For the readers of this blog, the story of Melanie Smith is very compelling. Melanie was diagnosed with colorectal cancer in 2002. She had several surgeries and underwent several drug therapies, few with any success. In late 2008, Melanie’s weight was down to 75 pounds and her doctor wanted to send her home on hospice. In 2009, Melanie switched physicians. Her subsequent doctor ordered Caris Target Now testing. The testing revealed that Melanie’s cancer overexpressed HER2, as well as exhibited other promising biomarkers with known therapeutic targets that have clinical trial evidence to support their use. Melanie was given Tykerb and Herceptin and responded well. Two years later, she is doing great. See Melanie’s HER2 story.

Other patient success stories include kidney cancer patient Douglas Luckow and breast cancer patients Sandy Fehrman and Barbara Levering.

The Journal of Clinical Oncology published a pilot study about the molecular profiling performed by Caris Life Sciences in October 2010. The study looked at biomarker based therapy among a group of patients with several different cancer types—all of whom had failed more than two previous lines of chemotherapy. In 27% of the patients, the approach in this study resulted in a longer progression free survival when compared to the regimen on which the patient had just experienced progression.

The news from ASCO this year was overwhelming. A study from researchers at M.D. Anderson Cancer Center in Houston found that one in four patients who had exhausted the standard of care therapies improved after getting a drug tied to the molecular ‘glitch’ feeding their cancer (this glitch is the type of finding discovered by Caris Target Now profiling).

Molecular profiling will pave the way to understanding the way cancer is approached. It is not perfect, but companies like Caris and institutions like M.D. Anderson are constantly working to evolve the science. Because the science is relatively new, there are still pathways and biomarkers to discover, and some cancers don’t have readily identifiable targets with related drug therapies. This is where molecular profiling can fall short –when a specific patient’s cancer doesn’t have a readily identifiable target for which there is a corresponding drug to treat it.

On another note, tumor sensitivity tests (the ones that are eloquently supported by a few bloggers on HER2support.org) are different from molecular profiling. Molecular profiling is performed by running a series of tests (DNA microarray, IHC, FISH, etc) to identify information about a patient’s tumor. This information includes the expression of various biomarkers that can help guide therapy. A chemosensitivity or chemoresistance assay takes cancer cells, isolates them, incubates them with various chemotherapeutic agents, assesses cell survival and interprets the results, which are usually recorded as drug sensitive, drug resistant or intermediate. Both approaches have their supporters and their detractors. This year ASCO focused on the pathway approach to better cancer therapies and firmly pointed to molecular profiling as the future to cancer discovery going forward.