What to expect from orthotopic PDX testing at Certis Oncology Solutions.
At Certis, our orthotopic approach to testing patient-derived xenografts (tissue implanted into another species), called PDXs, is validated by science. But it isn’t a familiar service or process for patients…or their doctors, for that matter. So, what can you expect? How does it all go?
First, talk with your oncologist.
If you are interested in our orthotopic testing, discuss it with your doctor. Are you candidate? Can it buy you more precious time? Can it help improve your quality of life? Given all the factors of your cancer and your life, is it right for you?
Give us a call.
All it takes to get started is for you and your doctor to say so. Call us with your questions, and we’ll explain the process, costs, timeline and other details of testing.
We’ll need your consent…and your tumor tissue.
Your written consent and initial investment are our official green light to get started. But first, we need to obtain a tumor sample. With your doctor’s help, a tissue sample from surgical biopsy or tumor resection surgery can be sent to our testing facility. We can also establish tumor lines in mice using the tissue from a core needle biopsy. This allows us to start as early as possible, which leads to earlier testing and results.
Certis can also find a biopsy provider near you if needed, and we’ll make all the arrangements with them to send us the tissue sample.
Next, we establish the tumor in the mice.
We implant the tissue from your tumor into multiple mice and proceed to “establish” the tumor. This means growing the tumor and “passaging” it into new mice so that it is stable and substantial enough for testing. Because we surgically implant the tumor tissue orthotopically (“in the correct place”) in the mice, it generally takes a few months to establish the tumors. This is much faster than with ectopic (“in the wrong place”) PDXs, such as subcutaneous grafts, which can take 6 to 9 months.
Until tumor lines are sufficiently established to begin testing, your investment is just $2,500. This covers not just tumor establishment but, if there is sufficient tissue, also tumor cryopreservation for future testing and potential future use for clinical trials. (It can cost $5,000 to $7,000 elsewhere for the cryopreservation and storing without tumor establishment.)
Time for testing.
Once the tumor line is established, it’s time to run the testing. For this, we’ll have already worked with your oncologist to determine which of the large number of available anti-cancer drugs to test on your tumor. Generally, we test just a handful of drugs, those that your doctor determines are most likely to benefit you based on all the various factors.
From tumor implantation, time to test results is usually 4+ months. This is considerably faster than with PDXs that aren’t orthotopic.
What should you expect while we’re busy testing?
You’ll be kept informed by your doctor about our progress or any important developments or needs. But the fact is that you’re not involved in the testing. Because we test on your “mouse avatars,” you have no travel, no time spent and no toxic exposure related to our testing.
If you’re in cancer treatment, stay in it; our testing will not disrupt it. Otherwise, go about your life. Some patients like to check up on their mice, and some even give them names.
After testing, you and your doctor make the decisions.
Like other medical test providers, the results go to your oncologist. Your doctor will evaluate our findings, consider them in the context of all the other factors of your life and cancer, and make informed decisions with you about which drug therapy will be most likely to give you…
- More precious time
- A higher quality of life
- Your best chance of remission