[Rich66]

Hmmm. Having an oncology company rep meet with a support group seems..unusual. Feels a little too close to selective marketing considering you had to come here to learn about other options.
Eh..back to your friend..

Maybe this will be helpful:

There are no guarantees the chemosensitivity test results will prove true if used to choose treatment. Same for markers like ER or Her2. Those are routinely used to guide treatment choices but have no guarantees either.
The same is true for testing antibiotics against cells from patients with infections. You could take a look at characteristics of the bacteria and the type of infection and pick some antibiotics through averages or experience. That would be similar to observing markers on a slide and using that to guide choice. But often, when a route to gather an adequate sample is available, say a urine sample for UTI, it is typical to test various antibiotics against the sample to see which one kills the bug. Results from that test suggest starting points for best chance of controlling the infection before resistance sets in. No guarantees..just a better informed starting point.That would be more like the functional profiling/chemosensitivity test.

The need for a larger than normal biopsy is the main hinderance, to my mind, of functional profiling. It seems typical that Interventional Radiologists unfamiliar with FP and/or its benefits will balk at taking multiple biopsy passes on an organ like the liver. Some have gone to California and had procedures done there by folks who are more on board with the idea. Although benefits may outweigh the negatives, I personally have some concern about extensive surgery in cancer patients considering general anesthesia can suppress the immune system and surgery can disseminate cancer cells. But again, if it leads to identifying a powerful treatment that really gets the job done, probably outweighs the negatives. If there is enough sample, FP can allow for testing of drugs and off label combinations not normally considered.

Another issue is that FP doesn't test for sensitivity to endocrine therapy (Tamoxifen, Femara etc)..probably because endocrine therapies take time (sometimes months) to work whereas FP evaluates cancer cell death within a brief time window. Sometimes they will combine Tamoxifen with chemo, but the evaluation window is still brief. But if endocrine therapies have been exhausted or the cancer is considered ER negative, less of an issue.