HER2 Support Group Forums - View Single Post - any tumor tests to predict which chemos work better?

gdpawel · 03-01-2012, 09:02 AM

Amanda

The measurement of molecular profiling (called genotyping analysis) is gene expression, examining a single process (pathway) within the cell or a relatively small number of processes (pathways) to test for "theoretical" candidates for targeted therapy.

The measurement of functional profiling (called phenotyping analysis) is expression of cell-death, both tumor cell death and tumor associated endothelial (capillary) cell-death (tumor and vascular death), and examines not only for the presence of the molecular profile but also for their functionality, for their interaction with other genes, proteins and other processes occuring within the cell, and for their "actual" response to anti-cancer drugs (not theoretical susceptibility).

Phenotype (functional profiling) analyses, which measure biological signals rather than DNA indicators, provides clinically validated information and plays an important role in cancer drug selection. A more highly productive direction would be to investigate the targeting agents in each individual patient's tissue culture, alone and in combination with other drugs, to guage the likelihood that the targeting will favorably influence each patient's outcome.

Sarah

I sincerely believe you're correct in saying this. Since the late 1980's, the NCI, aided by study sections, effectively closed down research into fresh human tumor cell culture methods for testing and optimizing chemotherapy. The proof of this is the complete lack of NIH-funded studies relating to this topic appearing in PubMed for the last twenty years. Thanks for private researchers in keeping it alive.

As one clinician has put it, we have put all of our clinical trials resources into trying to identify the best treatment for the "average" patient, in a disease notorious for heterogeneity. Drug screening (including therapy screening) belongs in the laboratory, not in the clinic.

In the last few years, there is a belated recognition that "personalized" therapy is a worthy goal, yet 100% of the effort is going into static profiling of molecular markers, as opposed to dynamic, functional profiling of tumor response ex vivo. Clinicians are now being forced into looking at "combined" targeted therapy ("FDA to alter rules for cancer drug cocktails").

How in the world are they going to accomplish this with "static" profiling? Examining a patient's DNA can give physician's a lot of information, but as the NCI has concluded (J Natl Cancer Inst. March 16, 2010), it cannot determine treatment plans for patients. It cannot test sensitivity to any of the targeted therapies. They just test for theoretical candidates for targeted therapy.

03-01-2012, 09:02 AM	#48
gdpawel Senior Member Join Date: Aug 2006 Location: Pennsylvania Posts: 1,080	Re: any tumor tests to predict which chemos work better? Amanda The measurement of molecular profiling (called genotyping analysis) is gene expression, examining a single process (pathway) within the cell or a relatively small number of processes (pathways) to test for "theoretical" candidates for targeted therapy. The measurement of functional profiling (called phenotyping analysis) is expression of cell-death, both tumor cell death and tumor associated endothelial (capillary) cell-death (tumor and vascular death), and examines not only for the presence of the molecular profile but also for their functionality, for their interaction with other genes, proteins and other processes occuring within the cell, and for their "actual" response to anti-cancer drugs (not theoretical susceptibility). Phenotype (functional profiling) analyses, which measure biological signals rather than DNA indicators, provides clinically validated information and plays an important role in cancer drug selection. A more highly productive direction would be to investigate the targeting agents in each individual patient's tissue culture, alone and in combination with other drugs, to guage the likelihood that the targeting will favorably influence each patient's outcome. Sarah I sincerely believe you're correct in saying this. Since the late 1980's, the NCI, aided by study sections, effectively closed down research into fresh human tumor cell culture methods for testing and optimizing chemotherapy. The proof of this is the complete lack of NIH-funded studies relating to this topic appearing in PubMed for the last twenty years. Thanks for private researchers in keeping it alive. As one clinician has put it, we have put all of our clinical trials resources into trying to identify the best treatment for the "average" patient, in a disease notorious for heterogeneity. Drug screening (including therapy screening) belongs in the laboratory, not in the clinic. In the last few years, there is a belated recognition that "personalized" therapy is a worthy goal, yet 100% of the effort is going into static profiling of molecular markers, as opposed to dynamic, functional profiling of tumor response ex vivo. Clinicians are now being forced into looking at "combined" targeted therapy ("FDA to alter rules for cancer drug cocktails"). How in the world are they going to accomplish this with "static" profiling? Examining a patient's DNA can give physician's a lot of information, but as the NCI has concluded (J Natl Cancer Inst. March 16, 2010), it cannot determine treatment plans for patients. It cannot test sensitivity to any of the targeted therapies. They just test for theoretical candidates for targeted therapy.