Know more Functional drug sensitivity testing using the IndiTreat® CRC Extend panel offers information about the sensitivity of individual patients’ tumors towards guideline-approved drugs and drug combinations, independent of biomarkers. Randomized controlled clinical trials, such as the RECOURSE1 study (TAS-102) and the CORRECT2 study (regorafenib) reported only modest median improvements in overall survival compared to placebo + best supportive care (RECOURSE: +2 months, CORRECT: +1.4 months). Individual patients do, however, benefit significantly from these treatments, thereby justifying the considerable adverse effects and costs associated with these drugs. Overall survival of refractory mCRC patients treated with either regorafenib or TAS-102 in a real world setting is very similar, with no biomarkers available to support treatment decision processes.3 Patient eligibility Patients with metastatic colorectal cancer (mCRC) showing tumor progression after at least two previous lines of systemic therapy are eligible for functional chemosensitivity testing using IndiTreat® CRC Extend. The IndiTreat® CRC Extend panel helps you to identify the individual response of your patient’s tumor to the drugs typically used in third- and further-line treatment options. 1 Van Cutsem E et al., Eur J Cancer 2018;90:63-72, 2 Grothey A et al., Lancet 2013;381(9863):303-12, 3 Nevala-Plagemann C et al., J Natl Compr Canc Netw 2023;21(3):257-264, 4 Ciardiello F et al., CA Cancer J Clin 2022;0:2-30, 5 Cervantes A et al., Ann Oncol 2023;34(1):10-32, 6 Strickler J et al., Ann Oncol 2022;33(suppl_7):S808-S869, 7 Schraa S J et al., Virchow Arch 2023;Online ahead of print Treatment Guidelines In cases where their CRC still progresses 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 offered.4,5 Most patients will be offered either standard chemotherapy (FOLFOX, FOLFIRI or FOLFOXIRI), orally administered chemotherapy with TAS-102 (trifluridine and tipiracil) or treatment with the multi-targeted kinase inhibitor regorafenib. Only approximately 10% of these patients carry druggable molecular alterations.3,6,7 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 Extend Panel support third- and further-line therapy decision-making by identifying patients with above average tumor sensitivities to guideline-approved treatments. FOLFIRI FOLFOX FOLFOXIRI trifluridine-tipiracil regorafenib Drug tested Low sensitivity Medium sensitivity High sensitivity FOLFIRI • FOLFOX • FOLFOXIRI • regorafenib • trifluridine-tipiracil • Low Medium High Current patient Sensitivity Overall Survival (in a real world setting) regorafenib TAS-102 Months Nevala-Plagemann C et al., J Natl Compr Canc Netw 2023 Ciardiello F et al., CA Cancer J Clin 2022; Cervantes A et al., Ann Oncol 2023 50 60 40 30 20 10 0 0.00 0.25 0.50 Survival Probability 0.75 1.00 RAS/BRAF WT trifluridine-tipiracil / regorafenib / rechallenge with anti-EGFR drugs irinotecan + cetuximab trifluridine-tipiracil / regorafenib encorafenib + cetuximab / clinical trials KRASG12C clinical trials RAS MT BRAFV600E HER2 NTRK MSI-H/dMMR anti-HER2 therapies larotrectinib / entrectinib anti-PD-1 +/- anti-CTLA-4 Treatment choice depending on prior therapies, pre-existing toxicities, patient performance status, molecular alterations IndiTreat® CRC Extend – Drug panel Ordering Code: 2CX-01-CRC-01 FOLFOX regorafenib FOLFIRI trifluridine-tipiracil FOLFOXIRI
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