FAQ

Molekulare Onkologie

1: What’s the story behind molecular oncology?

The discovery of specific genetic alterations in malignant tumors has opened up new directions in cancer research. Knowledge about the function of oncogenes and tumor proteins has fundamentally contributed to the understanding of the molecular and cellular principles of malignant growth. Based on these principles we carry out molecular analyses of genes involved in the emergence and progression of human cancers. We are particularly focused on aspects of:

• early detection of cancer • detection of minimal residual disease • sensitivity and resistance to anticancer therapy

Numerous molecular markers are available for the detection of circulating tumor cells in the bloodstream. From our wide panel of offered parameters we select the appropriate combination of analyses depending on each specific case.

Since carcinomas are of epithelial origin and epithelial cells are normally absent in blood, genes of epithelial cells can be indicative of circulating carcinoma cells. In this context, the cytokeratin genes (e.g. CK19, CK20) are suitable markers for some carcinomas. Depending on the origin of the tumor, genes which code for specific organ functions can be measured in the blood. For example, the detection of cells expressing the prostate specific antigen are indicative for circulating prostate carcinoma cells.

Further typical cancerous aberrations are mutations in oncogenes (e.g. K-ras), allelic losses, gene promoter hypermethylation, or overexpression of particular genes (e.g. erb-b2, EGFR). Genes are known to be silent in normal tissues but to be reactivated in malignant cells (e.g. telomerase, G250).

Once detected, the determination of resistance factors and metabolic properties of the tumor cells can provide important information for the selection of an appropriate therapy. For many anti-cancer drugs metabolic enzymes are known, whose differential expression in tumor cells may influence the effect of the therapy. Measuring the enzymatic activities of these metabolizing genes can give important information on how the tumor cells will respond to anti-cancer drugs and to asses which therapies will be the most suitable.

In recent years novel drugs were developed which are accurately directed against specific target molecules (e.g. Herceptin, Iressa, Gleevec, Cetuximab, Sutent, Lapatinib,...). A therapy with these specific inhibitor only appears to be rational if the molecular targets are present in the tumor cells. We use genetic analysis if these molecular drug targets are expressed in the isolated tumor cells and a therapy with these potent drugs is sensible.

2: What are the benefits of Biofocus

cells, high-risk and low-risk patients can be identified. High-risk patients may benefit from adjuvant therapies.

Resistance factors can be identified in these cells which can provide important information for setting up an optimized therapy. Molecular analysis may facilitate decisions about the:

early initiation of therapy
targeted, patient-specific therapy
identification of drug resistance
monitoring of therapy response

The analyses at Biofocus is a two-step process. In the first step we try to detect disseminated cancer cells from the bloodstream. Depending on the underlying type of tumor disease, we choose a panel of parameters which are relevant for the detection of disseminated cancer cells originating from this type of tumor. If disseminated tumor cells are detected, the patient may be considered on higher risk for a possible relapse. Our detection rate for CTCs is ca. 80% in advanced stage CA. This detection rate is lower in sarcoma and lymphoma.

If samples are positive for CTCs, we can anaylse in a second step the tumor cells for chemo-resistance markers to aid in selection of an appropriate therapy.

Since different tumors are treated with different drugs, the actual panel of drug modalities depends on the underlying type of tumor.

3: What kind of specimen does Biofocus need?

Our analyses are usually made from blood
We usually need about 20 ml of blood, provided in two heparinized glass BD Vacutainers, 10 ml, green cap
Comparable blood drawing devices are also suitable, however they must contain heparine as an anti-coagulant and must be made of glass.

Contact for ordering blood shipment kits:

North Amerika:	Cameron Packaging, Lima OH, phone: 4192229404 Cameron Packaging Website
Other countries:	Biofocus GmbH, phone +49 2361 3000-130 prix@biofocus.de

All blood sample must be shipped in an insulated container (foam box) with some REFRIGERATED (not frozen!) cooling bags enclosed. Ship the blood samples ASAP after they have been drawn.

Molecular determination of chemoresistance markers can also be done on other specimens like tumor tissues or biopsies.

Please inquire for detailed information about packaging and shipping of such materials

4: What is the cost?

For prices, please see the requisition form in the link

Requisition form

Test 1 Molecular Detection of Circulating Tumor Cells (CTCs)

By this assay, we only check if CTCs are present in the blood sample. Further assays like chemosensitivity testing or testing for use of alternative agents could be done afterwards without sending a new specimen.

Our detection rate for CTCs is ca. 80% in advanced stage CA. If we cannot find CTCs, we charge costs for test option #1 only.

Specimen required: 20 ml heparinized blood. Appropriate blood shipment kits at: www.cameronpackaging.com