Gene Expression Profiling

imagineit2010

Has anyone on here had Gene Expression Profiling done? At what point from diagnosis was it done? After reading the recent saddening news about Pat (and others)I can't help but think that alot of his pain could have been avoided if he'd been tested before treatment. From what I've read, proper gene expression profiling can give a reasonably accurate presumption whether the patient should even bother with Chemo, along with the likelihood they will respond at all to it. Of course it seems logical that this would be counter-productive for an Oncologist, who is paid for visits during treatment, to do this as part of the plan. I can imagine that someone given this info at planning stage would likely seek other(alternative) forms of treatment thus be a big money loss for the Onc. Why do so many people get tested AFTER they find no response to the Chemo? I believe there needs to be a push for standard G.E.P. for all cancer patients. This would be a huge benefit to those patients who don't have a good prognosis from conventional medicine to explore other treatments without the FEAR associated with chosing another path. The Kaplan–Meier estimator (also known as the product limit estimator)could give patients peace of mind with the tough decisions of taking Chemo/radiation or not. After all, that is one of the toughest decisions facing many cancer patients. How many patients are needlesly treated after surgery without any PROVEN benefit? They accept further treatment out of fear of recurrence when they may be at a genetically minimal chance of recurrence. I imagine this would be a big money saver for insurance companies as well.
Would you want to know, at the begining of treatment, that you likely won't respond to treatment? Also would you be more likely to seek alternative treatments?
Questions for my Doc. tomorrow...

gdpawel

Gene and Protein Tests vs Functional Tumor Cell Profiling
A failed attempt at chemotherapy is detrimental to the physical and emotional well being of patients, is financially burdensome, and may promote the onset of clinically acquired multi-drug resistance. It would be highly desirable to know what drugs are effective against particular cancer cells "before" these toxic agents are systemically administered.

Survival can be improved among patients whose chemotherapy regimens are individualized for them by means of Functional Tumor Cell Profiling studies involving novel cell culture assays for anti-kinase drug activity and microvessel viability.

Traditional clinical trials of pharmaceuticals in which patients are randomized to receive treatment have failed, in most cases, to identify a single “best” drug regimen to administer to all patients sharing a specific cancer diagnosis. This is particularly true in settings of metastatic and recurrent disease. And yet individual patients representing all types and stages of cancer are shown occasionally to benefit substantially from both targeted agents and from more traditional drugs.

The goal of individualizing treatment is broadly shared throughout the medical community. Therefore, much interest and funding has been directed toward development of gene and protein-based tests. Gene and protein testing are indirect approaches to chemotherapy selection which examine a single process within the cell or a relatively small number of processes. Their aim is to determine only if there is evidence of a theoretical predisposition to drug susceptibility. In this regard, gene and protein testing are “static profiling” approaches.

In contrast, the “functional profiling” approach involves real-time assessment of living cancer and endothelial cell behaviors in the presence or absence of anti-cancer or anti-angiogenic drugs. This method accounts not for only for the existence of genes and proteins but also for their functionality and for their interaction with other genes, other proteins, and other processes occurring within the cell.

Gene and protein testing involve the use of non-viable, formalin-fixed cells that are never exposed to chemotherapy drugs. Gene and protein tests cannot elucidate issues relating to drug uptake or show if the drug will be excluded from the cell before it can act or what changes will take place within the cell if the drug successfully gains entry. Neither can gene or protein tests discriminate among the activities of different drugs within the same class. Instead, gene and protein tests assume that all drugs within a certain class will produce essentially the same effect in the presence of a specific molecular expression even though clinical experience suggests that this is not the case. Nor can gene or protein tests detect drug synergy in combination.

Functional tumor cell profiling assesses the net result of all cellular processes occurring in real time when viable cancer cells actually are exposed to specific anti-cancer drugs. Functional profiling therefore can discriminate differing anti-tumor and anti-angiogenic effects produced by different drugs nominally within the same class. Functional profiling can also identify synergies in drug combinations. Rates of response and survival can be improved among patients whose chemotherapy regimens are individualized for them by means of functional tumor cell profiling involving novel cell culture assays for cytotoxic drug activity and microvessel viability.