Friday 22 December 2017

The test of the effectiveness of specific drugs on cancer cells obtained from one patient

Hello!

My mother has glioblastoma. The doctor offered us a test - "Onconomics Plus" (the test of the effectiveness of specific drugs on cancer cells obtained from one patient).

https://www.rgcc-group.com/index.php?page=test_onconomics_plus
Price: 1900 €
This laboratory has branches in many countries.

As written on their website:
Test "Onconomics Plus"
Provides information about the efficacy of specific drugs on the patient. The method includes two procedures (epigenetic analysis and viability assays) to validate the data. The efficacy of natural biological substances or extracts on cancer cells. The assessment is based on the three methods: the direct cytotoxic effect, the stimulation of the immune system and the inhibition of proliferative signals in the cancer cells.

Sample of the report:
https://www.rgcc-group.com/assets/PDF/Test.SamplesOfTheReport/OnconomicsPlus/Chemoagents-patient's-name.pdf



What do you think? Is this test necessary?
Can there be more effective tests?

3 comments:

  1. I would have to ask a few questions about this.

    Firstly, what is their success rate in actually finding circulating tumor cells in the blood of GBM patients? One study that came out a few years ago found that only 29 out of 141 (21%) of GBM patients had identifiable circulating tumor cells.
    http://stm.sciencemag.org/content/6/247/247ra101

    I would ask if you get your money back if they don't find any circulating tumor cells.

    The other consideration is that most of these chemos don't cross the blood-brain barrier very well, which is why most of them aren't used for brain tumors. However a small fraction of the drugs tested could be useful for brain tumors, and there is other testing that could be useful such as the gene expression profiling.

    The most commonly altered gene in GBM is EGFR (included in the onconomics panel under the alternate name C-erb-B1 ). So yes, it's possible this testing could provide some actionable information, but much it of won't be actionable. The same is true of next generation sequencing panels, where a few of the mutations might be targetable with drugs, but the majority aren't.

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    Replies
    1. Stephen, thank you very much for your reply!
      I, like many here, am a beginner in this sea of information.

      Maybe you could give a more useful test and where to order it in Europe (in Germany)? How much does such a test cost? Does it require blood samples or a tumor?

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    2. The question comes down to how much money you are able to spend.

      1900 Euros for the Onconomics testing is on the more affordable end of the spectrum and could yield some useful data.

      If you are interested in thorough genetic analysis, I would recommend CeGaT clinic in Germany, which provides high coverage sequencing of 710 cancer associated genes for 4950 Euros, or whole exome sequencing for 5950 Euros. This information could provide a guide to therapy (for example, EGFR inhibitors if EGFR was found to be amplified or mutated), but more importantly this information could potentially be used in creating a personalized peptide vaccine (but the pricetag would then go up considerably, into the multiple 10s of thousands of Euros). For this testing you would need to provide both a tumor sample and a blood sample. I would contact CeGaT directly for more information.

      A different kind of vaccine could be pursued with IOZK clinic in Koln Germany, where tumor antigens can be extracted from the blood if frozen tumor tissue isn't available.

      The expense is often the limiting factor in pursuing a vaccine. With limited funds, Onconomics would be reasonable if they can guarantee you'll get most of your money back if they fail to isolate circulating tumor cells.

      The single most useful test might be for EGFR amplification or overexpression. Your oncologist should be able to tell you a lab close to you where that could be done, if it wasn't done already (check the pathology report). Do you have a copy of the pathology report, and what sort of testing has already been carried out?



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