32% percent of new cancer diagnoses are breast cancer, making it the most wide-spread type of cancer in Germany. The majority of cases occur sporadically without apparent genetic background. Additionally, there are hereditary types of the disease.
The treatment usually consists of an individual combination of operations as well as radio-, hormone-, and chemotherapy. The selection of any given therapy is based on the results of clinical trials. Routinely, parameters such as the size of the tumor, the lymph node status in the axilla, histology, and grading find consideration, while few tumor biological criteria are considered in determining the individual treatment. The hormone receptor status (estrogen and progesterone), the HER2/neu-status, and the cellular proliferation (antigen Ki-67) are some markers that find consideration. However, these often do not provide a sufficient basis for an effective individual therapy since each breast cancer is as individual as a patient’s own fingerprint.
More than 20.000 genomes determine the tumor-biological behavior (growth rate, aggression, metastasis, response to treatment) of any given tumor, yet only a few find consideration in conventional cancer treatment.
While you can see less than 20% of an iceberg above the water line, the discernable amount of treatment-relevant tumor genes ranges only in the part-per-thousands.
New Means of Testing Characterize Tumors
New means of testing allow thoroughly characterizing a tumor. These innovative methods afford doctors an in-depth look at the tumor and thus an ensuing personalized cancer treatment for the patients. In the case of breast cancer, the patients’ questions about the nature of their disease and treatment can be reliably answered.
In the case of a first primary cancer, well-informed patients enquire whether they really need to go undergo a strenuous chemotherapy. This question is particularly relevant since annually, 10.000 patients diagnosed with breast cancer across Germany undergo a chemotherapy they neither need nor profit from.
Modern tissue analysis such as the EndoPredict test, the determination of proteases (uPA/PAI-1) as well as the PANTHER test can provide an answer to this question. For many patients, this leads to the question: “If I have to undergo a therapy, can it at least be one that has the biggest chance of success in my case?”
While the selection of any given chemotherapy is made on the basis of large clinical trials, this does not automatically allow for an assessment of an individual success rate. By using modern medical tests such as the 3D spheroid chemosensitivity test, an individual choice can be made. Additionally, the PANTHER test can be used to evaluate a specific chemotherapy’s, hormone therapy’s (tamoxifen, aromatase inhibitors), and immune therapy’s (Herceptin®) rate of success.
New Methods of Analysis Characterize the Tumor
The PANTHER-test makes an important contribution to personalized tumor treatment as it provides an extensive analysis of gene activity patterns. The 3D spheroid chemosensitivity test moves away from the trial and error principle of conventional cytotoxic treatment. Cytotoxic treatment offers uncertain prospects of success while severely limiting a patient’s quality of life. Thanks to new developments in molecular genetics and bio-medicine, targeted therapies are moving increasingly into the center of medical interest. Targeted therapies focus on a tumor’s individual characteristic mutations or on the increased activity of cancer genes on a molecular level. Innovative procedures such as the PANTHER-test in connection with the MultiOncogen Mutation tests (MOMs), which undertake a comprehensive mutation analysis of the most important cancer and tumor suppression genes, decipher the characteristics of individual cancer genes that offer the key to targeted therapies. Such combinable CancerGenomeLandscape assays are available in different variations according to the problem at hand.
Liquid biopsies are a new technique in which a tumor and the treatment tailored to it can be assessed without having to undergo an invasive operation. A mere blood sample is enough. Circulating tumor cells (CTCs) or circulating cell-free tumor DNA (cftDNA) form the basis of liquid biopsies. Using special techniques, CTCs can be isolated and offer insight into a procedure’s success rates. Highly efficient molecular biological techniques allow drawing sufficient RNA and DNA from just one or a few of these CTCs to determine the activity of all of the tumor’s genes via the PANTHER-chip test or MultiOncogen Mutation tests (MOMs). Should it be impossible to extract tumor cells from the blood sample, the MOMs can be used to identify therapeutically relevant mutations from circulating cell-free tumor DNA (cftDNA) in the serum. This test is of particular clinical importance since tumors treated with targeted therapy often change their mutational pattern after six months. If this happens, they no longer respond to the current therapy.
Gentle Cancer Treatment via Personalization
The innovations in developing individual vaccines are bringing the dream of personalized, highly specific and gentle cancer therapy closer to realization. New diagnostic tools, pan-genomic PANTHER gene activity testing and EXOM-MOMs make a significant contribution to the development of individual cancer vaccines.
With regard to the production of such vaccines in particular, it can be of critical importance to cryopreserve part of the tumor tissue after an operation. Uomorphis[LvC1] offers such cryopreservation, either as standard preservation frozen in the gas phase of liquid nitrogen at a temperature of under -190°C or as LIFE-cryopreservation, in which the tumor cells are isolated and frozen alive in a computer-controlled specialized medium.
To determine the best and most promising course of action in your case, you are very welcome to contact Prof. Bojar for a personal consultation.