New lifesaving technology can combat cancer

Imagine the benefits if there was technology that pinpointed exactly which chemotherapy drugs work best in fighting each individual's type of cancer. No more guessing. No more trial and error. The good news is that such lifesaving technology is on its way to becoming reality.

Clinical trials involving 38 patients at Wilshire Oncology Medical Group are yielding positive results. Wilshire has several offices in Southern California including Pomona, Rancho Cucamonga, Glendora, West Covina, Pasadena and La Verne.

Rancho Cucamonga resident Yvonne Cardinale has been a patient with Wilshire Oncology for about 18 years, being first diagnosed with an aggressive breast cancer in October 1993. "I went through five months of traditional chemotherapy and a stem cell transplant," Cardinale said. "Then it came back. I was re-diagnosed in February 2008 when it was found in the lining of my lung."

Dr. Linda Bosserman, Cardinale's Pomona-based doctor, is also president of Wilshire Oncology Medical Group. Bosserman approached Cardinale, now 58, with the idea of committing to a clinical trial of a chemosensitivity test or assay. Cardinale agreed.

Cancerous fluid was taken from Cardinale's lung and sent to DiaTech Oncology Corp., a private laboratory based in Nashville, Tennessee, for testing. DiaTech uses a microculture kinetic (called MiCK) assay test to help predict treatment outcomes and to help decide which chemotherapy would be best for specific patients. Various forms of chemotherapy were tried on Cardinale's cancer cells.

"I was given the two most effective drugs that worked on my cancer," she said. "I felt because of this study I had a real advantage. The drugs worked well, and I feel good." Cardinale, whose mother is also a breast cancer survivor, will take her last dose of chemotherapy this month.

"What this test does is expose cancer cells to various chemotherapy drugs in the lab. We just need some biopsied cancer cells or - if we're dealing with leukemia - blood," said Dr. Swapnil Rajurkar, lead medical investigator for Wilshire. "I get the results back from the lab saying, 'These drugs are likely to work and these are not.'" Rajurkar explained that breast cancer has about 10 approved drug treatments. It's up to the individual oncologist, depending on what's known about the patient's condition and the doctor's experience, to decide which treatments are used first.

"This is invaluable information," Bosserman said. "One of our biggest challenges is when we treat people we go by guidelines, but individual patients' tumors are unique and personal. By being able to find out what chemotherapies the patients might be responsive to, and what they are not going to respond to, we can save them weeks and months of getting treatment that is not going to help them - all of which have side effects and will decrease their quality of life.

"We're actually going into active treatment with one of the health plans where they're going to pay for this test ahead of time in patients and keep track of this additional data on how patients do," Bosserman said. "This means that for future patients, if the test says the drug will work, it will work."

On the flip side, if the test reveals a drug is useless against an individual's cancer, that patient would not have to go through an ineffective treatment. "This information really helps patients make decisions, especially if facing very advanced cancer where, we know a lot of times, those last-ditch treatments don't help patients and take up their valuable days of life," she said. "It really helps patients realize that they are not giving up hope, but can choose aggressive palliative care rather than treatment that really won't help them. The test offers the promise of adding more information to help guide better treatment decisions for patients."