IndiTreat® Therapy Design
The cornerstone of IndiTreat® therapy design is the IndiTreat® test that delivers comprehensive drug sensitivity analysis. From these tests, 2cureX has collected comprehensive knowledge on treatment regimens within different patient populations. This information can be made available to the oncologist to design the IndiTreat® screening panel of drugs to be tested on their patient’s tumor.
Adding to the growing body of information on the genetic characterisation of tumors, IndiTreat® drug sensitivity data can be used to support comparative studies of genomic mutations.
2cureX are also conducting exploratory research analysing the morphological characteristics of the microtumors using artificial intelligence algorithms.
The dilemma of choice in colorectal cancer treatment
For many years, the medical treatment of metastatic colorectal cancer has centered on chemotherapy with 5-FU, oxaliplatin and irinotecan as the backbone. In practice, chemotherapy consists of the regimens FOLFOX or FOLFIRI. As far back as 2004, Tournigand et al. documented the treatment results in a pivotal study*.
*J Clin Oncol 2004;22: 229-37
The outcome in this first-line head-to-head trial measured as response rate was around 55% for both regimens. It can be improved by addition of an anti-EGFR drug in RAS-wild type (WT) patients or an anti-VEGF drug in RAS-mutation (MT) patients as shown in other studies.
Today, the guidelines state that chemotherapy with either FOLFOX or FOLFIRI in metastatic disease is equally effective. In practice, the choice of 1st line therapy is based on local traditions, and side-effect profiles which may influence the choice of treatment. Oncologists usually start 1st line therapy with one regimen, and if it does not work or if resistance develops, the oncologist usually selects the other regimen as the 2nd line therapy.
Low response rate in 2nd line therapy
Treatment outcomes show that 45% of all patients treated are resistant to either FOLFOX, FOLFIRI or both regimens. Furthermore, the expectancy of treatment success in 2nd line therapy is relatively low.
Guidelines state that 70%–80% of fit patients should receive second-line therapy. However, the response rate to FOLFOX and FOLFIRI in 2nd line treatment is below 15%.
The resistance to FOLFOX6 and FOLFIRI increases to 85% in 2nd line treatment
The IndiTreat method can give valuable information for the prediction of the resistance or sensitivity to FOLFOX and FOLFIRI so that the patient could start treatment with the regimen that gives the best chance of achieving disease control. Additionally, a good response may make curative metastasis surgery possible.
The prospect of predicting resistance to oxaliplatin could prevent patients from developing neurosensorial problems caused by ineffective therapy. An important aspect to health economics is that an improvement in the likelihood of treatment enables better use of the clinic’s financial resources.
IndiTreat: the first CE validated IVD for monitoring cancer drug sensitivity
IndiTreat is a cancer drug sensitivity test based on patient-derived microtumors, aiding the oncologist in the decision to choose the most appropriate drug by directly testing a panel on the patient’s live tumor tissue.
Drug response in chemo-naive patients varies considerably
The pattern of drug response in chemonaive colorectal cancer patients varies considerably. Some tumors are resistant to all standard drugs and drug combinations, whereas some are sensitive for the most part and others react very differently to FOLFOX6 and FOLFIRI.
This variation in response stresses the importance of individual testing before treatment. Chemonaive patients may respond better to treatments, when drug resistance is identified as early as possible and those treatments are avoided.
Patient microtumors show considerable variation in response to different cancer drugs
Response is critical in third line metastatic colorectal cancer
Even in patients beyond progression on guideline-based therapy, the IndiTreat test can often identify one or two drugs to which the tumor is sensitive.
Presently, the prediction of treatment outcome by IndiTreat for several cancers is undergoing clinical validation in our ongoing, prospective studies. We expect to have further results to present to you in the first quarter of 2021.
Please contact 2cureX for more information