MONITORING THERAPY

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Early Determination of Response to Therapy

When a patient undergoes a new therapy, it is important to learn quickly whether or not the patient is responding to the treatment. If the patient is not responding, the oncologist can prescribe a different treatment, so the patient doesn’t lose precious time. Imaging is typically used to determine disease progression, but imaging requires the tumor to grow bigger to be detected. Data shows the possibility to provide information of treatment response in 30 days.

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A baseline blood sample is taken before therapy.  A second blood sample is taken about 30 days after the therapy.  The response to therapy is determined by comparing the results of the two samples:

  • Not working: Any CTCs detected in the second sample

  • Not working: CAML size  or number increased in the second sample

  • Some benefit from therapy: CAML size  or number decreased in the second sample

  • Ideal case:  no CAML or CTC in the second sample

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Sequential Monitoring of Tumor Marker Status During Therapy

Sequential monitoring of therapy is recommended, because tumors change. This is especially important when the drug is targeting a specific marker.

Case Study:

  • Patient was initially on Pazopanib, which targets pan-VEGF. The original expression of pan-VEGF was high, but it decreased over time. Patient’s cancer progressed as indicated by an increase in CAML size.

  • At the same time, the expression of PD-L1 became high.  The therapy was switched to Atezolizumab, an immunotherapy drug.  The patient’s CAML size decreased following the therapy.

This patient sample was processed to analyze three companion diagnostic markers: Pan-VEGF, PD-L1, and EGFR.

Monitoring Change of PD-L1 Expression

Immunotherapies work the best when the PD-L1 expression on the tumor is high.  Our clinical research shows that PD-L1 expression can change under a variety of situations.

Some examples that we have published on are related to changes during (i) chemoradiation therapy, (ii) Briacell’s cancer vaccine therapy, (iii) renal cell carcinoma case study above, and (iv) CytoDyn’s Leronlimab breast cancer trial.  The data shown is from the CytoDyn clinical trial. The majority of PD-L1 expression after therapy is much higher than before therapy.

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