Chemosenstivity – via blood test

I posted before (now expired)
We did foundation medicine; Caris/target now, oncopath molecular testing - for my wife metastatic breast cancer with neuroendocrine features (which is rare), but didn't get good useful info (or FDA approved drugs). Tried many chemo(s).

I know these are most popular &widely known ones for chemo assay & molecular profiling.

We don't have fresh tumor sample. Dr. is NOT willing to do biopsy to send to RT/Wiesenthal for fresh tissue.

I should have followed up based earlier reply. But, now trying to follow-up on this, as current treatments not working.

Will anybody recommend one over other between following three (or any other better test for this)? As it can be done using blood test, just to see if they provide any useful info. i.e between Biofocus, RGCC, Goodgene or any other?

Biofocus Institute for Laboratory Medicine in Recklinghausen Germany, email: prix@biofocus.de

The Research Genetic Cancer Centre (R.G.C.C.) Florina, Greece, email: jpapasot@doctors.org.uk

The Goodgene Molecular Genetic Testing Center, use to be in Korea and currently may be in Houston. www.goodgene.co.kr

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All I can tell you is the caveat about blood assays.

Getting tumor cells from blood maybe feasible for solid tumors, though usually only when the tumor is very advanced, and then only in small numbers. It seems plausible that you can get enough specimen from circulating tumor cells for solid tumors. It may be possible using PCR (Polymerase Chain Reaction) or similar technology for specific agents.

Only minute quantities of DNA are necessary for PCR. DNA can be amplified from a single cell. PCR amplification techniques raise considerable concerns regarding contamination from one specimen to another, creating the potential for false positive results. Clinical interpretation of PCR results may also be challenging.

But, PCR may be useful when culture is difficult due to the low numbers of the organisms, for lengthly culture requirements, or when there is difficulty in collecting an appropriate sample. Don't know if the results would be indicative of what would happen inside the human body.

They usually proliferate (grow) cancer cells from a small sample and subject those cells to chemo. Cells 'grown' in the lab will not behave the same way as the actual cancer cells do in your body's own environment. Because they test on subcultured cells (as opposed to fresh tumor cultures) and test the cells in monolayers (as opposed to three dimensional cell clusters), the cell grown in the lab will not behave the same way as the actual cancer cells do in your body's own environment.

Older technology assay tests failed because scientists looked to see which drugs inhibited the cancer cells' growth (cell-growth endpoint), not which chemotherapies actively killed the tumor cells (cell-death endpoint). Cancer wasn't growing faster than other cells, it's just dying slower. The newer assay testing technology connects drugs to patients by what 'kills' their cells, not by what 'slows' them down.

All of the work in the past twenty years in the cell culture field has been carried out largely on three dimensional (3D) clusters of cells (not monolayers). Work is done exclusively with three dimensional, floating, tumor spheroids. When you test the cells as three dimensional spheroids, they are many-fold resistant in vitro, just as they are in vivo (multicellular resistance). Even Johns Hopkins and the Washington University at St. Louis has discovered that 3D analysis is more accurate.

Greg

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As usual, Greg, you've given more pertinent info just when I need it...heading to onco this afternoon. Loved to hear that even JH and Wash. Univ have come on board to the science.

@Satamara, I know I've read posts concerning sending samples abroad (Langley/Lisa I'm pretty sure has mentioned it), so hopefully some of those with experience will answer you soon. My onco. is very against pulling another biopsy out as well. What a strange world we're muddling around in where the recipients are driving the givers instead of the opposite (not that many of our oncos are really being driven by our pushing, begging and cajoling for more help!)

blessings,
laura b.

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agree, Greg seem like Phd and expert on this area.

I am quite amazed by his wealth of knowlege and help greg providing to cancer community.

Sending blood test for chemo sensitivity doesn't seem like best approach. But we (in my wife case) don't have much choice as Caris, foundation didn't provide much useful info. And taking fresh tumor sample - my onco. is very much against it and afraid do it.

I read this one also: http://www.breasthealthproject.com/ChemosensitivityTesting.html.

couple of questions:
1) is there any chemo/CTC blood test done in USA (not biofocus, RGC) incase anybody know.
2) 3D) clusters of cells test - at JH and washinton univ. is that available now to order?
3) Any other promising chemo assay tests?

one thing I don't understand is:
I know cancer is bug in Europe also.

Will everybody in Europe/Austrailia/NZ use -
Caris, foundation, chemo assay tests?

reason for asking is - if cancer is equally prominent in Europe/Australia/NZ & such..is there any other equally promising test that we can take advantage & cross reference with test results from Caris/targetnow?
(particularly any promising - 1) NEW tests or 2) any tests that can be done on NOT fresh tissue or 3) blood)

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