[gdpawel]

Sarah

The choice of a lab is a technical consideration. The labs vary considerably with regard to technologies, approach to testing, what they try to achieve with the testing, and cost. Some labs have been offering these assays as a non-investigational, paid service to cancer patients, in a situation where up to 30 different drugs and combinations are tested, at two drug concentrations in three different assay systems. Absent the assays, the oncologist will perform "trial-and-error" treatment until he/she finds the right chemotherapy regimen.

However, some testing is still "trial-and-error" because the tumor analysis is based on the same clinical literature search (population study), which tries to match therapies to patient-specific biomarker information to generate a treatment approach. This is not really personalized medicine, but just a refinement of statistical data. In other words, information that may help when considering "potential" treatment options (theoretical analysis). It's never measured against your actual cancer cells. If you are okay with that, go for it!

Some testing takes the tumor with the surrounding tissue (intact and live) and then puts chemo on it to see which chemo (actually) kill the cancer cells. The ability to monitor cell "function" provides clinicians with a vital method to characterize and compare "activity" of actual live cells. Programmed cell death (apoptosis) is critical in cancer formation and is often used to determine if cells are functioning properly.

Functional profiling analysis measures biological signals rather than DNA indicators, provides clinically validated information and plays an important role in cancer drug selection. It "actually" measures the response of the tumor cells to drug exposure. Following this exposure, it measures both cell metabolism (metabolic) and cell morphology (structure), the integrated effect of the drugs on the whole cell, resulting in a cellular response to the drug, measuring the interaction of the entire genome.

In short, Caris is testing for mutations, while Rational Therapeutics and Weisenthal Cancer Group are testing for drugs. Rating the efficacy of population research vs rating the efficacy of drugs actually tested against your individual cancer cells. The choice is theoretical vs actual analysis. The choice of a lab is a technical consideration.

Greg