Find Effective Drugs before Starting the Therapy!

No two cancer therapies are the same!

There is a wide range of different drugs which can be applied in treatment of bladder cancer. This treatment includes classical chemotherapeutic substances, yet also immunotherapeutics are used. Which medication should be prescribed depends on different factors, e.g. the cancer stage and the general condition of the patient. In order to choose the right therapy there are medical guidelines for physicians. However, in some situations the guidelines do not give clear recommendations and propose equivalent treatment options.

Diagnostic assays can help to identify effective and ineffective drugs before the start of a therapy. The available spectrum of therapeutics can thereby be limited on the most promising substances. Our diagnostics contribute avoidance of unnecessary side effects as a consequence of an ineffective therapy and save valuable treatment time. Therefore we offer the following diagnostic tests:

 

  • CTR-Test® - An efficacy test working on living tumor cells

  • PCDx™ - A tumor-biomarker-analysis working on non-living, conserved tumor cells

  • Guardant360® - A tumor-biomarker-analysis working with blood


Guidelines for the Treatment of Bladder Cancer

Hereafter you can find an overview about guideline-recommendations, which are elaborated by medical specialist associations:

 

There are two different sub-types of bladder cancer to be distinguished: muscle invasive and non-muscle invasive bladder cancer. A muscle invasive tumor has already reached the muscle layer of the bladder wall. Therapy options vary depending on the cancer type.

Furthermore it has to be determined if the tumor metastasizes or not.

A second-line therapy is a therapy which is applied in case of an ineffective first-line therapy.

non-muscle invasive bladder cancer postoperative chemotherapy-instillation epirubicin
mitomycin C
thiotepa
pirarubicin
low-risk tumors (EORTC) after operation no further chemotherapy
intermediate-risk tumors (EORTC) adjuvant chemotherapy-instillation
adjuvant instillation-therapy with Bacillus Calmette-Guerin vaccine (BCG)
high-risk tumors (EORTC) adjuvant instillation-therapy with Bacillus Calmette-Guerin vaccine (BCG)
second-line therapy gemcitabine
muscle invasive bladder cancer combination therapies containing cisplatin e.g. MVAC
5-fluorouracil + mitomycin C
metastatic and/or advanced bladder cancer chemotherapy containing cisplatin cisplatin + gemcitabine
methotrexate + vinblastine + doxorubicin + cisplatin (MVAC)
chemotherapy without cisplatin gemcitabine + carboplatin
monochemotherapy
second-line therapy vinflunine
therapies containing platin
gemcitabine and/or paclitaxel

This table is based on the "S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des Harnblasenkarzinoms", issued by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V., AWMF), the German Cancer Society (Deutsche Krebsgesellschaft, DKG) and the German Society of Urology (Deutsche Gesellschaft für Urologie, DGU). [1]


Efficacy Tests of Drugs for Bladder Cancer

Which drugs can be tested in their efficacy by our diagnostic tests? The following tables give you information on the substances recommended by the guidelines, but also about further drugs which can be found as additional treatment options in literature. These substances are classified in the following categories:

In addition the frequently used combination therapies are listed below.

The testabilities for the CTR-Test®  and the PCDx™ are also given.

Chemotherapeutics

substance name

efficacy testable by

CTR-Test Logo

efficacy testable by

PCDx Logo

efficacy testable by

Guardant360 Logo

Referenz
carboplatin yes yes yes [1]
cisplatin yes yes yes [1], [2]
doxorubicin yes yes not yet [1], [2]
epirubicin yes yes not yet [1]
gemcitabine yes yes not yet [1]
methotrexate no yes not yet [1], [2]
mitomycin C yes yes not yet [1]
paclitaxel yes yes not yet [1]
pirarubicin no validation yet no biomarkers yet not yet [1]
thiotepa no validation yet no biomarkers yet not yet [1]
vinblastine yes no biomarkers yet not yet [1], [2]
vinflunine no validation yet no biomarkers yet not yet [1], [2]
 

Immunotherapeutics

substance name

efficacy testable by

CTR-Test Logo

efficacy testable by

PCDx Logo

efficacy testable by

Guardant360 Logo

Referenz
Bacillus Calmette-Guerin vaccine (BCG) no no biomarkers yet not yet [1]
 

Frequently Used Combination Therapies

substance name reference
5-fluorouracil + mitomycin C [1]
carboplatin + gemcitabine [1]
cisplatin + doxorubicin + methotrexate + vinblastine (MVAC) [1], [2]
cisplatin + gemcitabine [1]
gemcitabine + paclitaxel [1]

The drugs listed here were identified as potential therapy options after an accurate literature research. Completeness cannot be guaranteed. Status: September 2016.


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