Despite all the medical progress of recent years, the treatment of esophageal cancer still poses a serious challenge. This pertains as much to an effective pre-operative (neoadjuvant) treatment, the adjuvant chemotherapy and radiation as well as to biological courses of treatment that are not yet well established. In a situation in which little is known about the tumor biology of the disease, a massive research endeavor remains to be undertaken before oncological precision therapies can become a reality. However, an exacter molecular biological characterization of the tumor should pave the way for personalized treatment.
More than 20.000 genes 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 selection.
From a floating iceberg less than 20% is visible on the surface. In contrast, the percentage of treatment-relevant tumor genes routinely recognized by the oncologist is only a few in a thousand.
Clinically important innovative assays for esophageal cancer
NextGen Oncology offers a wide range of cutting-edge genetic analyses to uncover clinically relevant features of the individual tumor. These innovative methods offer oncologists an in-depth look at the tumor biology/genetics, thus paving the way to a personalized cancer treatment.
Our PANTHER Test makes an important contribution to an individualized tumor treatment as it provides a comprehensive analysis of clinically useful gene activity patterns. PANTHER comprises a complete gene expression chip transcriptome analysis augmented with immunohistochemical analyses and quantitative PCR analyses of genes with key functions in clinically important signal transduction pathways.
Various Gene Mutation Panels uncover genetic variations for a personalized targeted treatment in the context of precision oncology.
Our highly recommended ELE.PHANT Assay is a start-of-the-art contribution to a personalized treatment by precision oncology.
By Liquid Biopsy (LINK) a tumor and the treatment tailored to it can be assessed without having to undergo an invasive tumor tissue biopsy. A mere blood sample is enough. Circulating tumor cells (CTCs) or circulating cell-free tumor DNA (cftDNA) form the analytical basis of liquid biopsy. NextGen Oncology offers sensitive technologies for the determination of circulating tumor cells (CTCs) in the peripheral blood for estimation of the tumor burden and even more important for treatment response monitoring.
In this context, an analysis of the mutation spectrum of circulating free tumor DNA (cfDNA) in the patient’s blood plasma enables the monitoring of the response to a treatment with mutation-specific drugs. This test is of particular clinical importance since tumors treated with targeted therapy often change their mutational pattern within several months. If this happens, they no longer respond to the current therapy.
Cytotoxic treatment offers uncertain prospects of success while severely limiting a patient’s quality of life. Our chemosensitivity tests move away from the trial and error principle of conventional cytotoxic treatment. A prediction of response to a great variety of cytotoxic drugs and natural compounds is the focus of these tests.
Histological appearance of esophageal cancer
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.
Deep freezing of tumor tissue (Cryopreservation)
The standard procedure for the storage of tumor tissue involves formalin fixation and embedding of the fixed tissue in paraffin blocks (FFPE blocks). The quality of FFPE block tissue is quit often impaired by various formalin-fixation related artefacts. This can undoubtedly be a serious drawback for present and future analytical procedures. Keeping this in mind, it can be of critical importance to have higher quality tumor tissue at hand. Deep-freezing (cryopreservation) of the tumor tissue is the solution. Uomorphis as part of the NextGen Oncology Group 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.