Useful if the CTR-Test® should be performed later…
In case of cancer the tumor is often removed via surgery and the patient is subsequently treated with an according therapy with cancer drugs or radiotherapy. However in many cases it is not clear at the time of surgery which kind of therapy should be applied afterwards. One reason is for example that further investigations of the removed tumor tissue have to be performed to make a more precise statement about the cancer and its treatment. This occurs for example in a tumor board which takes place a few days after surgery.
The CTR-Test® was developed in order to test the lack of response (resistance) to a chemotherapy in advance and prevent the patient from an inefficient therapy with many side effects. The CTR-Test® however requires living tumor cells. Therefore the tumor is transported to TherapySelect in a special transport kit directly after removal. There the tumor tissue is immediately processed accordingly and used for the CTR-Test®. Thus it would be difficult to apply the CTR-Test® for patients, who require a chemotherapy in the end, although this was not certain when the tumor was removed. It is not possible to store the removed tumor without treatment for days or even weeks until the final therapy option is identified, since in this case no living tumor cells would be present anymore. To enable those patients to perform the CTR-Test® at a later time in case of a planned chemotherapy, TherapySelect offers the possibility of tumor storage.
Thereby living tumor cells are frozen in liquid nitrogen (cryopreservation) after surgery. If the treating physician and the patient decide to apply a chemotherapy at a later time, the stored tumor cells can be thawed up when required and used for a CTR-Test® to the same extent like freshly removed tumor cells. Thereby patients without a therapy plan at the time of tumor removal do not have any disadvantages for an individual treatment of their cancer.
How does the tumor storage (cryopreservation) work?
Tumor samples are cryopreserved to store them. This means that cell suspensions are stored in -196 °C cold liquid nitrogen. During biopsy or tumor removal a complete tissue block is removed from a patient. This block does not only contain tumor cells but also other cell types like blood, fat or immune cells and/or structuring tissue. To freeze tumor cells, which are still viable after the thawing process, these have to be purified from the tissue block. For purification the block is at first minced mechanically with the help of scissors or a scalpel. For the fine mincing, to the stage of microtumors, enzymes are used which dissolve the connections between cells. After centrifugation, to separate the cells from the waste products, the tumor cells, or microtumors respectively, can be frozen. Before that the amount of tumor cells in the sample is determined by a pathologist.
To not destroy the cells, the freezing has to be done slowly and carefully so that no ice crystals are formed which destroy cells. Therefore an “antifreeze agent” is used to cool down the cell lysates slowly and carefully to -80 °C. For a storage of several years the cell suspensions are stored in liquid nitrogen at -196 °C.
TherapySelect offers a storage period of 2 years. A longer period is not useful since a tumor is developing continuously and changes and thus the results from older tumor samples would not be informative for the current tumor sensitivity.
Upon request or necessity to perform the CTR-Test® the stored cells can be thawed up and the test can be performed normally.
Included services and costs
- Transmission of the tumor transport kit
- Purification of the tumor sample
- Storage of the tumor cells in liquid nitrogen up to 2 years
- Option to perform the CTR-Test®
- Costs are partly credited for the CTR-Test®
For the tumor storage a lump sum of 500 Euro is charged. It includes the purification of the tumor sample as well as the storage for up to 2 years. If a CTR-Test® is performed 250 Euro of the tumor storage costs are cross-charged with the total price of the CTR-Test®. Thus there is a reduced invoice when ordering the CTR-Test®.
1.995,- Euro (regular price for CTR-Test®)
- 250,- Euro (crediting of the tumor storage)
1.745,- Euro (price of the CTR-Test® with tumor storage)
Health insurance reimbursement
The reimbursement by the health insurances has to be requested for each individual case.