Functional Profiling – The New Chemosensitivity Testing
Currently, hundreds of drugs, drug combinations and targeted agents are used to treat cancer patients. With so many choices, how does your oncologist decide which ones are right for you? Generally, doctors use established regimens developed through randomized clinical trials to prescribe chemotherapeutic agents. These regimens are average solutions for the “average” patient. Regrettably, average treatments provide average outcomes, with the majority of patients failing to show significant improvement from these protocols.
Cancer is an individual disease, as unique as your fingerprint.
One way to help identify the best treatment option for you is to submit a living sample of your tumor for a chemosensitivity test. By having your living cells analyzed in the laboratory, you gain peace-of-mind knowing that your cancer has been exposed to many different chemotherapy drugs/combinations outside of your body (ex vivo), to identify the most effective, least toxic regimen based on your unique tumor biology.
Since the earliest introduction of cytotoxic chemotherapy, researchers have pursued laboratory techniques designed to match patients to available drugs. Most of the work, published through the 1980s, reflected the prevailing view that cancer cells grew more rapidly than normal cells; hence the way to treat malignant cells was to stop their growth.
More recent advances in our understanding of cancer biology have shown that cancer cells do not grow faster than normal cells, but instead, fail to die. Cancer cells are mutant cells that escape the normal process of programmed cell death and accumulate into what we recognize as tumors. Thus, drugs and therapies must be targeted to trigger cell death rather than prohibit cell growth.
Therefore, there are three absolute principles of accurate in vitro drug prediction:
- Measure cell death, not the inhibition of cell growth.
- Never grow cells in vitro. Once cancer cells are artificially stimulated to grow in the laboratory, they no longer represent the original cancer tissue.
- Preserve the ecology of cancer biology. Cancer cells interact with their environment and must be maintained in their human tumor microenvironment.
These three principles are significant advances over earlier methodologies where tumor cells were isolated and grown in the laboratory. These previous chemosensitivity tests, of which your oncologist may be familiar, did not have the capacity to predict active therapies, and were only able to identify therapies that did not have a high likelihood of response (extreme drug resistance).
We refer to this updated chemosensitivity test as a functional profile. Functional profiling provides a window into the dynamic 3-D process by which human tumor cells respond to therapy. By capturing cells within their natural microenvironment, human biology is recreated in the laboratory. The EVA-PCD platform provides a real-time snapshot of how human tumors behave within their natural microenvironment. Each microspheroid examined contains all the complex elements of tumor bio-systems, including the cell-cell, cell-stromal, cell-vasculature and inflammatory cell-cytokine exposure conditions, maintained in a 3-D human tumor microenvironment laboratory model. By examining small clusters of cancer cells in their native state, the tumor’s response to drug exposure is measured to identify which drug or drug combination induces programmed cell death.