Correkt-Chemo – Personalize your Chemotherapy


Cancer is a name given to a collection of related diseases. Cancer can start any place in the body, starting with cells growing out of control and crowding out normal cells. This makes it hard for the body to work the way it should. Cancerous tumors are malignant and they invade nearby tissues, travel to distant places in the body through the blood, forming new tumors far from the original tumors. Cancer can be treated very well for many people and can help them lead full lives.

Various therapies use medicines or drugs to treat cancer. Surgery and radiation therapy remove, kill, or damage cancer cells in a certain area, but chemotherapy can work throughout the whole body. Chemotherapy can kill cancer cells that have metastasized or spread to parts of the body far away from the primary (original) tumor. Multiple drugs with different actions can work together to kill more cancer cells. This can also reduce the chance that the cancer may become resistant to any one chemo drug.

Once a patient is diagnosed with cancer, routinely patient receives the “conventional / standard” chemotherapy regimens. These regimens are common to all patients with that particular cancer type. Such “one size fits all” approach is one of the most important reasons of treatment failure and cancer recurrence. To avoid such “trial and error” approach and to save the precious time, Correkt-chemo is a must for a successful cancer therapy management.

  • What is Correkt-chemo?

It is the only test available that identifies directly, the most effective chemotherapy drugs that can kill cancer cells. In this test, live tumor cells obtained from fresh biopsy are treated with different chemotherapy drugs and their combinations.  The effect of these drugs is studied in real time to analyze the direct efficacy of each cancer drug to kill the cancer cells. This allows oncologists to personalize and improve the treatment by selecting the best suitable drugs before starting chemotherapy.

  • How is Correkt-chemo helpful?

Not all drugs work the same on all patients. Some drugs may not prove beneficial and waste valuable time and resources at this critical point in treatment. With Correkt-chemo test, there is a way to know how effective the chemotherapy will be, before the start of treatment. It will help your oncologist choose the best chemotherapy regimen from the NCCN approved list. Correkt-chemo test directly measures the efficacy of chemotherapy drugs on your live tumor cells and provides a personalized efficacy profile of individual chemotherapy drugs. Thus instead of speculating about how effective chemotherapy will be by costly trial and error, we get that information well before beginning the therapy. It helps to identify at an early stage whether the treatment is likely to work or not and to spare patient’s the unnecessary toxicity of ineffective drugs. It helps to provide patient with the right treatment for the right target without delay.

Knowing the right chemotherapy from the very beginning is the best option. As fresh tumor sample is required, the test can be performed and results can be provided to you and your physician to aid in the determination of the best drugs for you, and you can ensure that you receive the most effective chemotherapy from all available options.

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Metastasis – Making the fight against cancer tougher


Cancer in itself is a traumatizing phase in anyone’s life. However, it is more painful when the cancer recurs after the treatment. Cancer recurrence happens due to many reasons. Metastasis is one of those.

About Metastatic Breast Cancer

Sometimes, the cancer spreads to the other parts of the body which are far from the spot where it originated. When breast cancer metastasizes, it is also classified as Stage 4 breast cancer.  It usually spreads to the the lungs, liver, bones or brain. Metastasis is the name of the process by which cancer spreads to the other parts. The chances of metastasis are most amongst breast cancer. The risk of metastatic cancer varies from person to person. Even though cancer spreads to other parts of the body, it is still treated as the original cancer. i.e. breast cancer spread to the lungs will still be considered and treated as breast cancer, not lung cancer.

 How does cancer metastasize?

Cancer usually metastasizes or spreads through one or more of the steps mentioned below-

  • Cancer cells invade healthy cells around them.

When the healthy cell is taken over by the cancer cells, it can replicate more abnormal cells and spread the cancer.

  • Cancer cells penetrate into the circulatory system.

Cancer cells travel through the walls of nearby lymph vessels or blood vessels. Sometimes, they get carried by the lymph system and the bloodstream to other parts of the body and it causes harm.

  • Cancer cells get stuck in capillaries.

Sometimes, cancer cells stop moving as they are lodged in capillaries at a distant location. There, they get divided then migrate into the surrounding tissue.

  • Micro metastases.

Micro metastases are the small tumors formed by cancer cells at the new location. This might make cancer cells spread.

Image credits - http://cache1.bioon.com/
Image credits – http://cache1.bioon.com/

Symptoms of Metastatic Breast Cancer

The symptoms of metastatic breast cancer vary depending on how far the breast cancer has spread and what type of tissue the new cancer growth has invaded. These symptoms may also vary depending on where the cancer has spread to.

Here are some common symptoms of breast cancer metastasis according to the various locations in the body.

Metastasis to the bone:

  • Bones that are more easily fractured or broken
  • Severe, progressive pain
  • Swelling

Metastasis to the brain:

  • Persistent, progressively worsening headache or pressure to the head
  • Vision disturbances
  • Seizures
  • Vomiting or nausea
  • Behavioral or personality changes

Metastasis to the liver:

  • Jaundice
  • Itchy skin or rash
  • Abnormally high enzymes in the liver
  • Abdominal pain, appetite loss, nausea, and vomiting

Metastasis to the lungs:

  • Chronic cough or inability to get a full breath
  • Abnormal chest X-ray
  • Chest pain

Apart from the above, other nonspecific systemic symptoms of metastatic breast cancer include fatigue, weight loss, and poor appetite.

If these symptoms are noticed in the breast cancer patient, be sure you talk with your physician.

Treatment of metastatic breast cancer is guided by many factors like characteristics of the cancer cells, location where the cancer has spread, its symptoms, and treatments used in past. This treatment is highly personalized and depends on the characteristics of cancer and tolerance of the patient. Side effects are also taken into consideration.

Today, many advanced treatments are available for metastatic breast cancer. Even though the treatments might not guarantee to cure the cancer completely, they definitely help to control it.

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Pharmacogenetics – Selecting Right Drugs For the Right Genes


Did you know that 87%of the total patients receiving cancer chemotherapy develop Adverse Drug Reactions (ADR)? It also causes 50 deaths out of 1000 patients in India. These statistics highlight the importance of correct drugs for the treatment.

Depending on your genetic makeup, some drugs may work more or less effectively for you than they do in other people. Likewise, some drugs may produce more or fewer side effects in you than in someone else.

Pharmacogenetics is the study of inherited genetic differences in drug metabolism which can affect individual responses to drugs, both in terms of therapeutic effect as well as adverse effects. It plays an important role in Oncology.

Now, doctors are able to use information about your genetic makeup to choose the drugs and drug doses that are helpful to you.

For example, if a patient asks for extra amount of codeine to relieve the pain, it can come across as a sign of an evading patient seeking narcotics. However, that patient can be breaking down the codeine within minutes of swallowing it and therefore not be able to create the intermediate molecule that relieves the pain. With this conclusion, the physician can suggest the suitable drugs.

image credits- static1.squarespace.com/
image credits- static1.squarespace.com/

Pharmacogenomics also help to save you time and money as the “best-fit” drug for you can be chosen from the beginning of the treatment to avoid the trial-and-error approach of giving you various drugs.

Besides pharmacogenomics, other factors may influence how a person reacts to a drug. These include:

  • Person’s age and gender.
  • How advanced the cancer is.
  • Person’s lifestyle habits, such as smoking and drinking alcohol.
  • Other diseases that they have and the medications they are on for these conditions.

FDA Guidelines for Pharmacogenetics

The U.S. Food and Drug Administration (FDA) has listed many drugs that need genetic testing before introducing them in the treatment. Some of them are Mercaptopurine and Irinotecan. FDA recommends genetic testing before giving the chemotherapy drug mercaptopurine (Purinethol) to patients with acute lymphoblastic leukemia. It also advises doctors to test colon cancer patients for certain genetic variants before administering irinotecan (Camptosar), which is part of a combination chemotherapy regimen.

Let us see some case studies so that we can understand how pharmacogenetic analysis helped patients with better drugs, and thus, treatment.

  1. A 62 year old male patient with colon cancer was started with a standard dose of FOLFOX and after 6 weeks, Irinotecan and Cetuximab were introduced. However, after the first cycle, sever Myelo-suppression was developed. It delayed the chemo for 3-15 days every cycle. At DGL, comprehensive pharmacogenetic analysis consisting of tumour mutation analysis was advised which confirmed ADR to Irinotekan and 5FU and capsitaben was recommended.
  1. 52 year old male Chronic Smoker diagnosed with adenocarcinoma of the Right Lung with liver metastasis was given Pemetrexed and Carboplatin- 6 cycles which showed partial response. He was advised comprehensive pharmacogenetic analysis at DGL consisting of Tumor mutation analysis for efficacy evaluation and Pharmacogenetics for toxicity profile that showed KRAS mutation which explains partial response to Pemetrexed. Other mutations detected suggestive of personalized targeted therapy.

Geneshield Test at DGL

This test at DGL requires sample of whole blood/ saliva and turnaround time is 2 weeks. The report will give you the information of the genetic mutations you carry that would affect the efficacy of drugs. This test also gives you information about the toxicity of these drugs on your body at the same time.

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It’s always better to maintain a good rapport with the doctor. Here are the few things which you should discuss with your doctor before starting a treatment.

  • Would you explain my treatment options?
  • Which treatment or combination of treatments do you recommend? Why?
  • What are the possible side effects of this treatment?
  • Is there a way to predict how the cancer will respond to this drug or whether I might experience severe side effects?
  • What are my options if the cancer does not respond to the drug or if I suffer from severe side effects?

Detecting the ill-effects of drugs and replacing them with proper ones under expert advice definitely help to give the treatment a right direction.

 

 

 

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