Find Effective Drugs before Starting the Therapy!

No two cancer therapies are the same!

There is a wide range of different drugs which can be applied in treatment of ovarian cancer. This treatment includes classical chemotherapeutic substances, yet also anti-hormonal drugs and new targeted drugs are used. Which medication should be prescribed depends on different factors, e.g. the cancer stage and the general condition of the patient. In order to choose the right therapy there are medical guidelines for physicians. However, in some situations the guidelines do not give clear recommendations and propose equivalent treatment options.

Diagnostic assays can help to identify effective and ineffective drugs before the start of a therapy. The available spectrum of therapeutics can thereby be limited on the most promising substances. Our diagnostics contribute avoidance of unnecessary side effects as a consequence of an ineffective therapy and save valuable treatment time. Therefore we offer the following diagnostic tests:

  • CTR-Test® - An efficacy test working on living tumor cells
  • PCDx™ - A tumor-biomarker-analysis working on non-living, conserved tumor cells
  • Guardant360® - A tumor-biomarker-analysis working with blood

Guidelines for the Treatment of Ovarian Cancer

Hereafter you can find an overview about guideline-recommendations, which are elaborated by medical specialist associations:

Drug therapy regimes differ for primary and recurrent ovarian cancer. While there are different options for primary treatment depending on the stage of cancer, platinum-based chemotherapy is generally recommended. If a patient suffers a relapse, the choice for an appropriate treatment is based on the time span between discontinuation of chemotherapy and the occurrence of the relapse. Tumors relapsing within 6 months are called platinum-resistant, those relapsing after 6 months are referred to as platinium-sensitive.

first-line therapy early ovarian cancer chemotherapy containing cisplatin (therapy should contain carboplatin)
advanced ovarian cancer carboplatin + paclitaxel (+ bevacizumab)
recurrence platinum-sensitive tumor carboplatin + gemcitabine + bevacizumab
carboplatin + doxorubicin (liposomal)
carboplatin + paclitaxel
carboplatin + gemcitabine
platinum-resistant tumor doxorubicin (liposomal)
topotecan
gemcitabine
paclitaxel

This table is based on the "S3-Leitlinie Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren", issued by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V., AWMF), the German Cancer Society (Deutsche Krebsgesellschaft, DKG) and the Germany Society for Gynaecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG). [1]


Efficacy Tests of Drugs for Ovarian Cancer

Which drugs can be tested in their efficacy by our diagnostic tests? The following tables give you information on the substances recommended by the guidelines, but also about further drugs which can be found as additional treatment options in literature. These substances are classified in the following categories:

In addition the frequently used combination therapies are listed below.

The testabilities for the CTR-Test®  and the PCDx™ are also given.

 

Chemotherapeutics

Substance name Efficacy testable by living tumor & blood (living cells) Efficacy testable by archived tumor (FFPE) Efficacy testable by blood (plasma) Reference
altretamine no validation yet no biomarkers yet not yet [3]
bleomycin yes no biomarkers yet not yet [2]
capecitabine yes yes not yet [3]
carboplatin yes

yes

 

yes

 

[1], [2]
cisplatin yes yes yes [2]
cyclophosphamide yes no biomarkers yet not yet [2]
docetaxel yes yes not yet [3]
doxorubicin yes yes not yet [3]
doxorubicin (liposomal) yes yes not yet [1], [2]
etoposide yes no biomarkers yet not yet [2]
gemcitabine yes yes not yet [1], [2]
irinotecan yes yes not yet [3]
melphalan yes no biomarkers yet not yet [3]
oxaliplatin yes yes yes [3]
paclitaxel yes yes not yet [1], [2]
pemetrexed no yes not yet [3]
topotecan yes yes not yet [1], [2]
trabectedin yes not yet not yet [1]
treosulfan yes no biomarkers yet not yet [1]
vinorelbine yes not yet not yet

[3]

 

 

Targeted Drugs

Substance name Efficacy testable by living tumor & blood (living cells) Efficacy testable by archived tumor (FFPE) Efficacy testable by blood (plasma) Reference
bevacizumab no yes not yet [1]
olaparib no validation yet yes yes [3]

 

Anti-Hormonal Drugs

Substance name Efficacy testable by living tumor & blood (living cells) Efficacy testable by archived tumor (FFPE) Efficacy testable by blood (plasma) Reference
anastrozole not possible yes yes [3]
exemestane not possible yes yes [3]
letrozole not possible yes yes [3]
leuprorelin not possible not yet not yet [3]
megestrol no validation yet yes not yet [3]
tamoxifen yes yes yes [3]

 

Frequently Used Combination Therapies

Substance name Reference
bleomycin + cisplatin + etoposide phosphate (combination name: PEB) [2]
bevacizumab + carboplatin + gemcitabine [1]
carboplatin + cyclophosphamide [2]
carboplatin + gemcitabine [1], [2]
carboplatin + paclitaxel [1], [2]
carboplatin + doxorubicin (liposomal) [1], [2]

The drugs listed here were identified as potential therapy options after an accurate literature research. Completeness cannot be guaranteed. Status: September 2016.

 

Sources

[1] S3-Leitlinie Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren; Version 1.0 - Juni 2013; Leitlinienprogramm Onkologie der AWMF

[2] Engelhardt, Monika; Berger, D.; Duyster, J.; Mertelsmann, R. (Hrsg.): Das Blaue Buch: Chemotherapie-Manual Hämatologie und Internistische Onkologie. Berlin, Heidelberg: Springer, 2014 — ISBN 978-364-24174-1-2

[3] NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ®) – Ovarian Cancer; Version 1.2016

Tumor Category
Submitted by Dr. Frank Kischkel on