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 breast cancer. This treatment includes classical chemotherapeutic substances, yet also anti-hormonal drugs and new targeted drugs 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 Breast Cancer

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


A part and parcel of the medical breast cancer treatment is the anti-hormonal therapy. It has to be distinguished if the woman's menopause has already set in or not. If a patient has not yet entered menopausal years, GnRH-analogs can be prescribed additionally. These analogs result in an elimination of the ovarian function. Though not all breast tumors respond to an anti-hormonal therapy. The efficacy of an anti-hormonal treatment can be tested in advance of therapy start.

Chemotherapeutics and targeted drugs are also a part of standard therapy. Generally two or three chemotherapeutic agents are used in a combination therapy.

 

Anti-Hormonal Drugs

locally limited primary diseasepremenopausaltamoxifen
tamoxifen + GnRH-analogs
postmenopausalaromatase inhibitors
tamoxifen
local recurrence
aromatase inhibitors
tamoxifen
distant metastasespremenopausalaromatase inhibitors + GnRH-analogs
tamoxifen + GnRH-analogs
high-dose gestagens
postmenopausalaromatase inhibitors
fulvestrant
high-dose gestagens
 

Chemotherapeutics and Targeted Drugs

locally limited primary diseasechemotherapyanthracyclines (e.g. doxorubicin, epirubicin)
taxanes
anthracyclines + taxanes
targeted drugstrastuzumab
local recurrence
selection of substances appropriate to previous therapy
distant metastaseschemotherapyalkylating agents
anthraquinones
anthracyclines
capecitabine
eribulin
fluoropyrimidines
platinum complexes
taxanes (e.g. docetaxel, paclitaxel)
vinorelbine
targeted drugsbevacizumab
lapatinib
trastuzumab


This tables are based on the "Interdisziplinäre[n] S3-Leitlinie für die Diagnostik, Therapie und Nachsorge des Mammakarzinoms", 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 Germany Society for Gynaecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG) [1].


Efficacy Tests of Drugs for Breast 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

Reference
5-fluorouracil (5-FU)yesyesnot yet[1], [2], [3], [4]
capecitabineyesyesnot yet[1], [2], [3], [4]
carboplatinyesyesyes[1], [2], [3], [4]
cisplatinyesyesyes[2], [4]
cyclophosphamideyesno biomarkers yetnot yet[1], [2], [3], [4]
docetaxelyesyesnot yet[1], [2], [3], [4]
doxorubicinyesyesnot yet[1], [2], [3], [4]
doxorubicin (liposomal)yesyesnot yet[1], [2]
epirubicinyesyesnot yet[1], [2], [3], [4]
eribulinno validation yetyesnot yet[1], [3], [4]
gemcitabineyesyesnot yet[1], [2], [3], [4]
ixabepiloneno validation yetno biomarkers yetnot yet[4]
methotrexatenonot yet
not yet[1], [2]
paclitaxelyesyesnot yet[1], [2], [3], [4]
vinorelbineyesnot yet
not yet[1], [2], [3], [4]



Targeted Drugs

substance name

efficacy testable by

CTR-Test Logo

efficacy testable by

PCDx Logo

efficacy testable by

Guardant360 Logo

Referenz
bevacizumabnoyesnot yet[1], [3], [4]
everolimusno validation yetyesyes[4]
lapatinibno validation yetyesyes[1], [3], [4]
palbociclibno validation yetyesnot yet[4]
pertuzumabno validation yetyesyes[1], [3], [4]
trastuzumabno validation yetyesyes[1], [2], [3], [4]
trastuzumab emtansineno validation yetyesyes[3], [4]


 

Anti-Hormonal Drugs

substance name

efficacy testable by

CTR-Test Logo

efficacy testable by

PCDx Logo

efficacy testable by

Guardant360 Logo

Referenz
anastrozolenot possibleyesyes[4]
ethinyl estradiolno validation yetno biomarkers yetnot yet[4]
exemestanenot possibleyesyes[1], [3], [4]
fluoxymestronenot possibleno biomarkers yetnot yet[4]
fulvestrantno validation yetyesnot yet[3], [4]
goserelinnot possibleno biomarkers yetyes[4]
letrozolenot possibleyesyes[4]
leuprorelinnot possiblenot yet
not yet[4]
megestrolno validation yetyesnot yet[4]
tamoxifenyesyesyes[1], [3], [4]
toremifeneno validation yetyesnot yet[4]


 


Frequently Used Combination Therapies

substance namecombination namereference
5-fluorouracil + cyclophosphamide + doxorubicinFAC[2]
5-fluorouracil + cyclophosphamide + epirubicinFEC[2]
5-fluorouracil + cyclophosphamide + methotrexateCMF / Bonadonna[2]
bevacizumab + capecitabine
[1], [3]
bevacizumab + paclitaxel
[1]
capecitabine + docetaxel
[1]
capecitabine + lapatinib
[1], [2]
capecitabine + paclitaxel
[1], [4]
capecitabine + trastuzumab
[1], [4]
capecitabine + vinorelbine
[1]
carboplatin + docetaxel + trastuzumabTCH[2]
carboplatin + gemcitabine
[2]
cisplatin + gemcitabine
[2]
cisplatin + gemcitabine + trastuzumab
[2]
cyclophosphamide + docetaxelTC[2], [3]
cyclophosphamide + docetaxel + doxorubicinTAC[2]
cyclophosphamide + doxorubicinAC[2], [3]
cyclophosphamide + doxorubicin + paclitaxel
[2]
cyclophosphamide + epirubicinEC[2]
cyclophosphamide + epirubicin + paclitaxelETC[2]
docetaxel + doxorubicin
[1]
docetaxel + epirubicin
[2]
docetaxel + gemcitabine
[1]
docetaxel + pertuzumab + trastuzumab
[2], [3], [4]
docetaxel + trastuzumab
[2], [4]
doxorubicin + paclitaxel
[1]
epirubicin + paclitaxelEP[1], [2]
gemcitabine + paclitaxel
[1]
gemcitabine + vinorelbine
[1]
lapatinib + trastuzumab
[3], [4]
paclitaxel + trastuzumab
[2]

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