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Myeloma Tumor Chemosensitivity Testing

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Myeloma tumor chemosensitivity testing sounds like an oxymoron. Myeloma is a blood cancer- no such thing as a myeloma “tumor.” However, it seems like chemosensitivity testing should be the first step for all newly diagnosed cancer patients in general and oncology should be able to test blood cancers as well as solid tumors.

Let’s be clear about why  I’m writing about chemosensitivity testing for multiple myeloma.  Chemotherapy is the ultimate double-edged sword. It causes as many risks to the patient as it does benefits for the patient.

Some chemotherapy regimens are cytotoxic to MM. Some are not. All chemotherapy regimens cause damage to DNA, cause senescence, damage your immune system, etc.- in short, chemotherapy causes a host of short, long-term and late stage side effects.

My point is that if you have been diagnosed with MM,  it is in your best interest to undergo as little chemotherapy as possible in your lifetime.

So when you are first diagnosed with MM,  why doesn’t your oncologist take a blood sample and test it to find out which MM chemo regimen is cytotoxic to your MM?

First and foremost, I have to say that I don’t know why conventional oncology does or does not do anything. What I do know is that if the Food and Drug Administration (FDA) has not approved tumor chemosensitivity testing for MM, oncology will not prescribe it.

If you really want to know why your onc. doesn’t order tumor chemosensitiviy testing for you, you will have to ask them.

Which cancers benefit from chemosensitivity testing?

Chemosensitivity testing, also known as chemosensitivity assay or drug sensitivity testing, can be beneficial for various types of cancers, especially those that are difficult to treat or have become resistant to standard chemotherapy. Some cancers that may benefit from chemosensitivity testing include:

  1. Breast Cancer: Especially in cases where hormone therapy and standard chemotherapy options have been exhausted or are ineffective.
  2. Lung Cancer: Particularly non-small cell lung cancer (NSCLC), which can often develop resistance to chemotherapy drugs.
  3. Colorectal Cancer: Especially in advanced stages or when traditional treatments are not effective.
  4. Ovarian Cancer: Particularly in recurrent or refractory cases where multiple lines of chemotherapy have been tried.
  5. Pancreatic Cancer: Due to its aggressive nature and limited treatment options, chemosensitivity testing may help identify effective chemotherapy drugs.
  6. Brain Tumors: Such as glioblastoma multiforme, where personalized treatment approaches are crucial due to the blood-brain barrier and tumor heterogeneity.
  7. Melanoma: Especially in metastatic melanoma where targeted therapies and immunotherapies may have been exhausted.
  8. Leukemia and Lymphoma: Particularly in cases where standard chemotherapy regimens have failed or when personalized treatment approaches are necessary.
  9. Sarcoma: Due to its rarity and heterogeneity, personalized treatment approaches based on chemosensitivity testing may be beneficial.

The main reason why I think oncology does not prescribe tumor chemosensitivity testing for MM patients is explained in the third article linked below. The article cites “ intratumor heterogeneity” for limiting the predictive power of chemo testing. Unfortunately, MM is all about intratumor heterogeneity. 

Therefore chemosensitivity testing is “limited” and therefore may not help you all that much. However, it you can afford it, it may be a worthwhile starting point.

I am a long-term cancer survivor with first hand experience of chemotherapy regimens that damage and don’t help. 

Are you a newly diagnosed MM patient? To learn more about both conventional and non-conventional MM therapies send me an email- David.PeopleBeatingCancer@gmail.com

Hang in there,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Tumor Chemosensitivity Assays Are Helpful for Personalized Cytotoxic Treatments in Cancer Patients

Tumor chemosensitivity testing (TCAs), also known as drug response assays or individualized tumor response tests, have been gaining attention over the past few decades. Although there have been strong positive correlations between the results of these assays and clinical outcomes, they are still not considered routine tests in the care of cancer patients.

The correlations between the assays’ results (drug sensitivity or resistance) and the clinical evaluations (e.g., response to treatment, progression-free survival) are highly promising.

However, there is still a need to design randomized controlled prospective studies to secure the place of these assays in routine use. One of the best ideas to increase the value of these assays could be the combination of the assay results with the omics technologies (e.g., pharmacogenetics that gives an idea of the possible side effects of the drugs).

In the near future, the importance of personalized chemotherapy is expected to dictate the use of these omics technologies. The omics relies on the macromolecules (Deoxyribonucleic acid -DNA-, ribonucleic acid -RNA-) and proteins (meaning the structure) while TCAs operate on living cell populations (meaning the function). Therefore, wise combinations of TCAs and omics could be a highly promising novel landscape in the modern care of cancer patients…”

chemosensitivity assay

“(KEE-moh-SEN-sih-TIH-vih-tee A-say)
A laboratory test that measures the number of tumor cells that are killed by a cancer drug. The test is done after the tumor cells are removed from the body. A chemosensitivity assay may help in choosing the best drug or drugs for the cancer being treated.”

The prospects of tumor chemosensitivity testing at the single-cell level

“Abstract- Tumor chemosensitivity testing plays a pivotal role in the optimal selection of chemotherapeutic regimens for cancer patients in a personalized manner. High-throughput drug screening approaches have been developed but they failed to take into account intratumor heterogeneity and therefore only provided limited predictive power of therapeutic response to individual cancer patients.

Single cancer cell drug sensitivity testing (SCC-DST) has been recently developed to evaluate the variable sensitivity of single cells to different anti-tumor drugs. In this review, we discuss how SCC-DST overcomes the obstacles of traditional drug screening methodologies. We outline critical procedures of SCC-DST responsible for single-cell generation and sorting, cell-drug encapsulation on a microfluidic chip and detection of cell-drug interactions. In SCC-DST, droplet-based microfluidics is emerging as an important platform that integrated various assays and analyses for drug susceptibility tests for individual patients.

With the advancement of technology, both fluorescence imaging and label-free analysis have been used for detecting single cell-drug interactions. We also discuss the feasibility of integrating SCC-DST with single-cell RNA sequencing to unravel the mechanisms leading to drug resistance, and utilizing artificial intelligence to facilitate the analysis of various omics data in the evaluation of drug susceptibility. SCC-DST is setting the stage for better drug selection for individual cancer patients in the era of precision medicine.

Biomarker Testing for Cancer Treatment

“What is biomarker testing for cancer treatment?

Biomarker testing is a way to look for genes, proteins, and other substances (called biomarkers or tumor markers) that can provide information about cancer. Each person’s cancer has a unique pattern of biomarkers. Some biomarkers affect how certain cancer treatments work. Biomarker testing may help you and your doctor choose a cancer treatment for you.

There are also other kinds of biomarkers that can help doctors diagnose and monitor cancer during and after treatment. To learn more, visit the Tumor Markers fact sheet.

Biomarker testing is for people who have cancer. People with solid tumors and people with blood cancer can get biomarker testing…”



Leave a Comment:

Deborah Rogow says last month

Thank you for this valuable info, David. I’m currently at City of Hope Hospital, having undergone a CAR-T procedure. And I’m trying to decide about whether to take maintenance chemo or not, and if so, which drug (probably mezigdomide).

    David Emerson says last month

    Hi Debbie-

    I have not read any studies about maintenance chemo post CAR-T either way. Sorry I cannot provide more info.

    Good luck,

    David Emerson

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