IndiTreat

Know more In approximately 20% of patients, colorectal cancer (CRC) is diagnosed in stage IV1,2. At this point, there may typically be four lines of treatment. The additional knowledge provided by IndiTreat® CRC Start lets you select the treatment sequence that will most likely provide the maximum benefit to your patient. Patient eligibility Newly diagnosed patients with metastatic CRC (mCRC, synchronous metastases) or previously treated localized disease with new onset of metastases (metachronous metastases) and an indication for first-line systemic therapy are eligible for functional chemosensitivity testing using the IndiTreat® CRC Start panel. First- and second-line treatment Speedy descision-making is especially important in mCRC treatment. The benefit to these patients can be maximized when starting with the chemotherapy that most potently impacts their tumor. Chemotherapy administered to patients at this stage generally entails a cytotoxic doublet such as FOLFOX or FOLFIRI. Although the average efficacy of these drug combinations is deemed similar, individual patient responses may differ. Clinical evidence demonstrates that choosing the more beneficial treatment sequence may considerably benefit patient survival3. Functional drug sensitivity testing using the IndiTreat® CRC Start panel provides additional insight into the impact of the drug combinations used typically in first-line mCRC treatment. 1 Primavesi F et al., Cancer 2019;11(2):218, ² Ciardiello F et al., CA Cancer J Clin 2022;0:2-30, ³ Abraham J P et al., Clin Cancer Res 2021;27:1174-8, ⁴ Gong J et al., J Gastrointest Oncol 2016;7(5):687-704, ⁵ Buchler T, Front Oncol 2022;12:888181, ⁶ Chu J E et al., Clin Cancer Res 2020;26(17):4599-605 Standard of Care Colorectal cancer patients with unresectable metastatic disease are offered first-line systemic therapy, most often composed of a chemotherapy backbone of up to three cytotoxic agents and the addition of a targeted therapy. Targeted therapies are selected based on molecular biomarkers, a strategy unsuitable for identifying the most advantageous chemotherapy for individual patients. Ciardiello F et al., CA Cancer J Clin 2022 5FU FOLFOX FOLFIRI FOLFOXIRI IndiTreat®. Decisive innovation in mCRC. The IndiTreat® CRC test is performed on patientderived tumoroids and, as a CE-marked IVD test, is available for daily 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 IndiTreat® CRC Start panel can support first-line therapy decision-making by identifying the most effective chemotherapy backbone for a given patient with metastatic CRC. RAS/BRAF WT Left chemo. doublet + anti-EGFR drugs Right chemo. doublet + bevacizumab / CT triplet + bevacizumab chemo. doublet+bevacizumab / CT triplet+bevacizumab / clinical trials chemo. doublet + bevacizumab chemo. triplet + bevacizumab chemo. doublet + anti-EGFR drugs pembrolizumab MSI-H/dMMR RAS MT BRAF V600E mCRC ca. 60%4 ca. 5%5 ca. 40%4 ca. 10%6 Unprioritized Standard of Care treatment sequence Abraham J P et al., Clin Cancer Res 2021 Increased benefit treatment sequence Median Overall Survival (months from treatment start) Responders to FOLFOX followed by FOLFIRI Responders to FOLFIRI followed by FOLFOX 24.5 18.7 42 34.4 Drug tested Low sensitivity Medium sensitivity High sensitivity 5-fluorouracil (5FU) • FOLFOX • FOLFIRI • FOLFOXIRI • Low Medium High Current patient Sensitivity IndiTreat® CRC Start – Drug panel Ordering Code: 2CX-01-CRC-02 5-fluorouracil (5FU) FOLFIRI FOLFOX FOLFOXIRI

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