The IndiTreat® CRC Explore panel provides additional insight into your patient’s tumor by showing the impact approved off-label drugs and drug combinations are having on patient-specific tumoroids in-vitro. Know more Functional testing using IndiTreat CRC Explore offers information about the actual sensitivity of individual patients’ tumors towards approved drugs and drug combinations outside of guidelines, independent of biomarkers. Overall survival in mCRC beyond second line is low (approx. five months with Standard of Care) and improvements in median overall survival upon therapy with drugs in off-label use are modest. Despite the limited median survival improvements, certain patients do benefit ‘significantly’ from the treatments, so available antineoplastics are worth exploring. Side effects and financial burden need to be weighed against potential patient benefit on a case-to-case basis. Patient eligibility Patients with metastatic colorectal cancer showing tumor progression after at least two previous lines of systemic therapy are eligible for functional chemosensitivity testing using IndiTreat® CRC Explore. Treatment Guidelines Upon disease progression after two previous lines of treatment, mCRC patients may receive ”re-challenge” therapy with chemotherapeutics to which their tumors responded in first-line. Alternatively, drugs recommended for third-line treatment in international guidelines may be The IndiTreat® CRC Explore panel provides an additional rationale for the use of selected antineoplastics for treating third- and further-line mCRC patients. 1 Maravic Z et al., ESMO Open 2020;5(5):e000850. 2 Petrelli F et al., Anticancer Drugs 2016;27(6):488-95. 3 Jiménez-Fonseca P et al., Clin Transl Oncol 2015;17(5):384-92. 4 Morano F et al., Ann Oncol 2018;29(8):1800-06. offered. Additional treatment options may be available to few selected patients via participation in clinical trials1. Therapeutic strategies with approved off-label drug regimens in colorectal cancer, such as mitomycin C plus fluorouracil, gemcitabine plus fluorouracil or temozolomide plus irinotecan, may also be used, depending on health authorities’ specific policies, and can benefit individual patients outside of clinical trials2,3,4. Types of treatment received by mCRC patients across Europe IndiTreat® Decisive innovation in mCRC decision-making The IndiTreat® CRC test is performed on patient-derived tumoroids and, as a CE-marked IVD test, is available for routine clinical use. Chemosensitivity data of individual patients is reported against a reference database of previously tested CRC patients, allocating the individual patient to one of three sensitivity categories (high, medium, low). Test results of the Explore Panel inform third- and further-line therapy decision-making by identifying tumor sensitivities to considered off-label treatments. * irinotecan-sensitive tumors bearing MGMT methylation regorafenib 6.5 months Grothey et al. Lancet 2013;381 (9863):303-12 trifluridine-tipiracil 7.2 months Van Cutsem E et al., Eur J Cancer 2018;90:63-72 mitomycin C + capecitabine 7.5 months Petrelli et al. Anticancer Drugs 2016;27(6):488-95 gemcitabine + capecitabine 6.5 months Jiménez-Fonseca et al. Clin Transl Oncol 2015;17(5):416-7 temozolomide + irinotecan *13.8 months Morano et al. Ann Oncal 2018;27(8):1800-1806 Drug regimen Media overall survival Source 100 80 60 40 20 0 Surgery Chemotherapy Radiotherapy Personalized/ targeted medicine Other (such as Immunotherapy or clinical trials) In Eastern European countries in other European countries (+Turkey) gemcitabine + 5FU trifluridine-tipiracil regorafenib temozolomide + irinotecan Low Medium High Current patient Sensitivity trifluridine-tipiracil • regorafenib • gemcitabine + 5FU • temozolomide + irinotecan • mitomycin + 5FU Not tested Drug tested Low sensitivity Medium sensitivity High sensitivity IndiTreat® CRC Explore – Drug panel Ordering Code: 2CX-01-CRC-03 trifluridine-tipiracil mitomycin + 5FU regorafenib temozolomide + irinotecan gemcitabine + 5FU