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Test May Help Predict
Chemotherapy Response



Excerpt By Jacqueline Stenson, Reuters Health

NEW YORK (Reuters Health) - An experimental test may help doctors quickly determine whether a particular regimen of chemotherapy is working, saving crucial time if another treatment approach is warranted, preliminary research suggests.

Cancer patients usually undergo four or five courses of chemotherapy before physicians can tell whether the treatment is having an effect, said Dr. Neil Steinmetz, medical director of the Theseus Imaging division of North American Scientific, Inc., the company that is developing the new test. By that time, the tumor may have grown so large that it is too late to switch to another chemotherapy regimen or the patient may be so weakened by the treatment that trying another approach is not immediately feasible, he said.

"That's a central dilemma of modern oncology," Steinmetz told Reuters Health. "We treat a lot of patients and we don't know going in if the treatment will work."

But the new test, known as Apomate, can predict whether chemotherapy is working in some cancers after just one dose, according to findings released Monday at the annual meeting of the American Association for Cancer Research in San Francisco, California.

The test works by measuring changes that occur on the surface of cancer cells as they are dying, Steinmetz explained. As the cells die, a component of the cell membrane called phosphatidylserine (PS) migrates to the membrane's outer surface. With Apomate, patients are injected with a solution that contains both a human protein known as annexin V, which binds to PS, and a radioactive tracer that releases a signal that can be viewed outside the body with an imaging device. The stronger the signals, the greater the cancer cell death, he noted.

Steinmetz reported on a trial involving 15 Belgian patients with inoperable lung cancer, breast cancer or lymphoma who were given the Apomate test both before and after their first dose of chemotherapy and then followed for up to a year. Results showed that all seven patients who had a positive result on Apomate following their first course of chemotherapy responded either partially or completely to the entire course of treatment. On the other hand, six of eight patients who had a negative result failed to respond to treatment and either their disease progressed or they died.

The test was most accurate for the 10 patients with lung cancer. "The key observation is that in the lung cancer cases, none of the patients who showed no cell-death activity after the first dose of chemotherapy responded to (continuing) chemotherapy," Steinmetz said.

The test may need to be refined in different ways for different cancers, he said. "We think it could certainly work for many if not all cancers," he added.

Studies of Apomate are currently under way in the United States, according to Steinmetz, and the test could be available within the next couple of years.


Reference Source 89

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