[gdpawel]

I can empathsize with the frustration. Nothing was presented at the 2009 American Society of Clinical Oncology (ASCO) breast cancer symposium, in San Francisco, reporting any progress at all in drug selection through the use of molecular profiling.

Little progress has been made in identifying which therapeutic strategies are likely to be effective for individual patients. Identifying markers that can predict response to a particular drug remains a great challenge.

When microarrays and high throughput RT-PCR emerged some years back, you'd think that there would be quite a bit of progress by now. Sad to say, there has not.

However, a study was presented at the symposium about progress in drug selection through the use of cell-based functional profiling.

The data presented clearly showed the utility of cell culture assays in “targeting” chemotherapy to patient sub-groups who are most likely to benefit from treatment with given individual drugs.

Genomics is far too limited in scope to encompass the vagaries and complexities of human cancer biology when it comes to drug selection. Efforts to administer targeted therapies in randomly selected patients often result in low response rates at significant toxicity and cost.

All the mutation or amplification studies can tell us is whether or not the cells are "potentially" susceptible to this mechanism of attack. They don't tell you if one targeted drug or another targeted drug is worse or better than the other or some other drug which may target this.

The cell is a system, an integrated, interacting network of genes, proteins and other cellular constituents that produce functions (processes). It would be a benefit to analyze the systems’ response to drug treatments, not just one target or pathway.

While researchers continue to develop molecular probes to select candidates, the cell culture analysis platform serves as a functional profile capable of examining the nuances of cellular response to drugs. To exploit the full potential of targeted anticancer therapies, physicians will need laboratory tests that match patients to specific drugs.

Cell culture assays are able to accurately predict how an individual patient's cancer cells will respond to an array of drug combinations. It is able to quantify synergistic drug combinations and individually tailor treatment.