Trending with Impact: Exacta® Guides Treatment and Identifies HER2

In a case presentation paper, Encyclopedic Tumor Analysis guided researchers in identifying HER2 overexpression in a patient with distal common bile duct carcinoma and in personalizing his treatment regimen.

Microscopic ductal cell carcinoma. Adenonocarcinoma from human breast cancer tissue. Magnification 400X
Microscopic ductal cell carcinoma. Adenonocarcinoma from human breast cancer tissue. Magnification 400X

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Researchers from multiple highly-regarded institutions located in India and from the Medical College of Wisconsin in the United states wrote a paper on the case presentation: “Liquid biopsy and multi-analyte testing guided treatment of HER2 positive periampullary adenocarcinoma with durable complete response after trastuzumab based therapy”—published in Oncotarget.

Out of people living with periampullary adenocarcinoma, 12% of patients show a mixed subtype with both intestinal and pancreatobiliary differentiation. The researchers in this study present a case of a 55 year-old male patient with distal common bile duct (CBD) carcinoma. This patient had undergone multiple surgeries and treatments only to present with continued disease progression, until he opted for multi-analyte testing to help find a new target mechanism and treatment.

Using Encyclopedic Tumor Analysis (ETA, Exacta®), the researchers found that the HER2 gene was overexpressed in the CBD carcinoma, and proceeded to employ this oncogene as a therapeutic target using trastuzumab, a recombinant humanized anti-HER2 monoclonal antibody.

“Encyclopedic Tumor Analysis (ETA) (Exacta®) offers integrative multi-analyte investigations of the tumor which captures in depth information about the multi-layered tumor interactome.”

With the help of this tool, the tumor-associated cells in vitro and circulating in the blood were isolated and analyzed to help the researchers design a personalized chemotherapeutic regimen of chemotherapy agents in combination with trastuzumab. The team reported that the patient with this distal CBD subtype of periampullary carcinoma displayed excellent durable response after the HER2 targeted therapy and personalized treatment, designed using Exacta®.

“It is well known that the histological subtype and genetic signature of the patient may influence the prognosis and treatment response and investigation of molecular profile of the patient could provide opportunities to design personalized treatment regimen for better prognosis and survival.”

Their study suggests that the HER2 gene is an effective pathway to target when treating the subset of HER2 amplified CBD carcinomas, and that multi-analyte Exacta® testing can be highly effective when identifying candidate genes and a therapeutic regimen for potential targeted therapy with chemosensitivity testing.

Click here to read the full scientific paper, published in Oncotarget.

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