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 stomach cancer. This treatment includes classical chemotherapeutic substances, yet also 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 Stomach Cancer

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

Patients with stomach cancer receive perioperative chemotherapy, that is, treatment begins prior to the operation and is continued afterwards. Palliative tumor treatment, that aims at improving quality of life, requires testing overexpression of HER-2 (a growth factor receptor). Therapy is then selected accordingly.

perioperative therapy ECX (epirubicin + cisplatin + capecitabine)
XP (capecitabine + cisplatin)
ECX (epirubicin + cisplatin + capecitabine)
palliative drug therapy no HER-2-overexpression DCF (cisplatin + 5-fluorouracil + docetaxel)
CF (cisplatin + 5-fluorouracil)
XP (capecitabine + cisplatin)
ECF (epirubicin + cisplatin + 5-fluorouracil)
ECX (epirubicin + cisplatin + capecitabine)
EOF (epirubicin + oxaliplatin + 5-fluorouracil)
EOX (epirubicin + oxaliplatin + capecitabine)
FLO (5-fluorouracil + leucovorin* + oxaliplatin)
FLP (5-fluorouracil + leucovorin* + cisplatin)
IF (irinotecan + 5-fluorouracil)
XI (irinotecan + capecitabine)
irinotecan + 5-fluorouracil + leucovorin*
HER-2-overexpression cisplatin + fluoropyrimidine + trastuzumab

*Leucovorin (folinic acid) is not a chemotherapeutic. It enhances the effect of 5-fluorouracil.

This table is based on the Leitlinie Magenkarzinom - "Diagnostik und Therapie der Adenokarzinome des Magens und ösophagogastralen Übergangs", 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 Gastroenterology and Digestive Metabolic Diseases (Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten, DGVS). [1]


Efficacy Tests of Drugs for Stomach 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
5-fluorouracil yes yes not yet [1], [2]
capecitabine yes yes not yet [1], [2]
cisplatin yes yes yes [1], [2]
docetaxel yes yes not yet [1], [2]
epirubicin yes yes not yet [1], [2]
irinotecan yes yes not yet [1], [2]
oxaliplatin yes yes yes [1], [2]

 

Targeted Drugs

substance name

efficacy testable by

CTR-Test Logo

efficacy testable by

PCDx Logo

efficacy testable by

Guardant360 Logo

Referenz
trastuzumab no validation yet yes yes [1], [2]

 

Frequently Used Combination Therapies

substance name combination name reference
5-fluorouracil + cisplatin + leucovorin* FLP [1]
5-fluorouracil + docetaxel + leucovorin* + oxaliplatin FLOT [2]
5-fluorouracil + irinotecan + leucovorin* Folfiri [1], [2]
5-fluorouracil + leucovorin* + oxaliplatin FLO [1]
5-fluorouracil + cisplatin CF [1]
5-fluorouracil + cisplatin + docetaxel DCF [1]
5-fluorouracil + cisplatin + epirubicin ECF [1], [2]
5-fluorouracil + cisplatin + trastuzumab [1], [2]
5-fluorouracil + epirubicin + oxaliplatin EOF [1]
5-fluorouracil + irinotecan IF [1]
capecitabine + cisplatin XP [1]
capecitabine + cisplatin + epirubicin ECX [1]
capecitabine + cisplatin + trastuzumab [1], [2]
capecitabine + epirubicin + oxaliplatin EOX [1], [2]
capecitabine + irinotecan XI [1]

*Leucovorin (folinic acid) is not a chemotherapeutic. It enhances the effect of 5-fluorouracil.

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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