CHEMOFIT

ChemoFit™ is a new laboratory test (the first of its kind in Canada) which helps identify the best chemotherapy for a patient’s unique tumour. We are very pleased to offer this test to eligible cancer patients to customize their treatment.

ChemoFit™ – What is it?

ChemoFit™ is a specialized chemosensitivity/chemoresistance assay (CS/CR Assay). CS/CR assays use a patient’s own tumour cells in the laboratory to identify which drugs have the most as well as the least potential for treating the patient’s unique cancer. This information can increase the success of chemotherapy and reduce unnecessary toxicity.

CS/CR assays are being used by many cancer centres in the United States to guide treatment. CS/CR assays are used routinely in selecting chemotherapy for ovarian, lung, breast, colon, prostate, cervical cancers as well as sarcomas.

Different assays use different methods to get results. ChemoFit™ uses one of the most advanced technology which is over 99% accurate for identifying resistant drugs and 87% accurate for identifying effective drugs.

What are the benefits of using ChemoFit™ to guide chemotherapy?

Oncologists presently choose chemo regimens based on clinical experience and general research data, combined with the patient’s medical condition. This approach does not take into account that every patient’s tumour is unique in the way it grows, and responds to treatment. ChemoFit™ will allow your oncologist to eliminate the regimens that are least likely to work and concentrate on the ones that have the most potential for killing your unique tumour.

Current studies show that cancer patients administered chemotherapy after laboratory tests like ChemoFit™ respond more favorably to the treatment. Studies are also showing a better survival for patients treated with drugs identified
as the most effective by the tests.

Who should consider ChemoFit™?

ChemoFit™ is recommended to guide chemotherapy for solid tumors like ovarian, lung, breast, colon, prostate, cervical, endometrial, pancreatic cancers and sarcomas. ChemoFit™ can be used for selecting both first line and second line chemotherapy, whether the aim of chemotherapy is cure, or palliation.

What if my oncologist says ChemoFit™ is not necessary?

ChemoFit™ is the latest in a new generation of tumour assays. Since it is being offered for the first time in Canada, your oncologist may not yet be familiar with the advantages of using this test.

Tumour assays have been around for more than two decades. However, until recently, their accuracy has been less that ideal. You oncologist may be basing their opinion on the older generation of tests.

Rapid advances in technology now allow tumour behaviour in the lab to accurately predict tumour behaviour in your body. Newer tests are measuring true indicators of tumour response to chemo like cancer cell death (while older tests measured reduction in tumour growth). More and more studies are emerging where test-guided chemotherapy is shown to improve treatment outcomes including survival.

With most cancers, there are many choices of chemo regimens. The oncologist typically chooses regimen based on an educated guess (called “empiric therapy”). The treatment of cancer is now moving away from empiric therapy to individualized treatment. A new generation of tests (like ChemoFit™) is starting to change the way chemotherapy is chosen. As with all innovations, it will take time for ChemoFit™ to gain widespread acceptance among Canadian oncologists.

How can I get ChemoFit™?

Cancer patients should Contact Medicor Cancer Centre (Medicor) at 416-227-0037 to discuss their individual medical history, and suitability for the test. Medicor will organize all elements of the test for eligible patients.

ChemoFit™ requires a fresh tumour sample Patients who are not candidates for surgery or who have already had surgery often can have a small office-based procedure performed to obtain a tumour sample for the ChemoFit™ test.

Is there any data supporting the use tumour assays?

Data supporting the use of tumour assays is emerging steadily and is very encouraging. Studies show that cancer patients administered chemotherapy after in vitro evaluation, respond more favourably to the treatment with resultant decreased toxicity.

Cortazar P, Johnson, B.E., Review of the Efficacy of Individualized Chemotherapy Selected by in-vitro
Drug Sensitivity Testing for Patients With Cancer, Journal of Clinical Oncology, 17(15):1625-31, May 1999

Strauss E., Pre-testing Tumours, Scientific American, 280(2):19,22, Feb 1999

Simonsen, M., Growth is Forecast for Tumour Markers, Oncogene Assay Market, American
Health Consultants, 1(4):1-6, 1998

Meta-analysis studies further indicate that there is a more favourable response in patients treated with regimens based on in-vitro assay results.

Cortazar, A., Johnson, M., Meta-analysis Studies in Patients Treated With Regimens Based on in-vitro Assay Results Than Those That Are Not, Journal of Clinical Oncology, 1999

In addition, patient survival has been shown to correlate with administering assay-guided therapy.

Mehta, R. et al., Breast Cancer Survival and in vitro Tumour Response in the Extreme Drug Resistance Assay,
Breast Cancer Research and Treatment, 66:225-237, 2001

Loizzi, V., et al., Survival Outcomes in Patients With Recurrent Ovarian Cancer Who Were Treated With
Chemoresistance Assay Guided Therapy, American Journal of Obstetrics and Gynecology, 189(5):1301-7, 2003

What makes ChemoFit™ the ideal tumour assay?

With ChemoFit™:

• Results are available within 72 hours.
• Tumor cells are exposed to drug concentrations that are physiologically achievable.
• Tumor cells are exposed to single drugs as well as combinations of drugs.
• On-protocol drugs, off-protocol drugs, novel drugs “in the pipeline” and “orphan” drugs can be evaluated.
• Cell growth inhibition is not evaluated (due to inaccuracies of this method).
• The end point is cell death, regardless of pathway (apoptosis alone as an end-point is not a sufficient indicator of cell-death).
• All causes of cell death are measured (drugs that target cell cycle parameters, signal transduction pathways, angiogenesis inhibition etc. can be evaluated).
• No pathological interpretation is required (interpretation is subjective).
• The cells analyzed are non-clonogenic, giving a better representation of the heterogenic cell mass within the tumour (yielding a better indication of the chemotherapeutic response).
• Several different drug concentrations are evaluated to minimize false positives and false negatives.

Please contact Sylvane at 416-227-0037 to coordinate the ChemoFit™ test.