OncoDiscover® CTC Test provides a potent real-time monitoring system that will help in understanding the spread of cancer and the effectiveness of therapy.
Case Studies
Below are some of the patient case-studies:
Case Study 01Patient Details
Female
74 yrs
Clinical Presentation
Ca Breast
pT2pNO HR+/ HER2–
Clinical History
Patient underwent surgery.
We advised ONCOTYPE Dx but patient was unaffording.
We needed to decided between adjuvant chemotherapy and hormonal therapy.
Test Result
4 CTCs were found with 1 CTC Cluster indicating highly aggressive disease.
Given her age – it was difficult to tolerate chemo.
4# TC – hormonal therapy X 7.5 yrs
Clinical Outcome
Case Study 02Patient Details
Male
45 yrs
Clinical Presentation
CA rectum
Clinical History
NACT+RT – Sx- CT (delayed due to myelosuppression).
PET Scan and CTC test done at end of therapy.
Test Result
4 CTCs were found with 1 CTC Cluster indicating highly aggressive disease.
PET Scan confirmed multiple liver mets.
Patient underwent surgery.
Patient was unaffording for chemo and expired shortly.
Clinical Outcome
Case Study 03Patient Details
Female
60 years
Clinical Presentation
CA Breast
ER-/PR-/HER2 3+
Clinical History
Sx-L.MRM-pT2N0
CHEMO-6 #TCH +2 # Herceptin (no funds)- on f/u.
PET Scan and CTC test suggested.
Test Result
2 CTCs were found indicating residual disease.
PET Scan confirmed liver mets.
Meta analysis by TMH suggests that 6 months Herceptin is equal to 12 months.
In this particular case, 6M of Herceptin was not enough as patient developed liver mets.
Clinical Outcome
Case Study 04Patient Details
Female
60 years
Clinical Presentation
CA Breast
Suspicious lung nodules on PET SCAN
Clinical History
Sx –RT.MRM- pT2N2MO
CHEMO- ACX 4- TH X4 – Herceptin x 17 doses
CTC test was done post surgery and post chemotherapy.
Test Result
2 CTCs were found Surgery.
0 CTCs were found post chemotherapy.
After 17 cycles of Herceptin, since CTC and PET was normal, hence we stopped at 1 yr of therapy.
Clinical Outcome
Case Study 05Patient Details
Female
64 years
Clinical Presentation
Ca Ovary
Stage IIIC
Clinical History
NACT x 3 #pacli –Carbo - ICS – Adj chemo X 3 # Pacli – Carbo-On f/u
CTC test was suggested post treatment.
Test Result
1 CTC were found in CTC Cluster form indicating aggressive residual disease.
CA125 was within normal limits.
CT scan – local recurrence
Patient was put on Oral Metronomic Chemotherapy (OMCT)
Clinical Outcome
Case Study 06Patient Details
Female
33 years
Clinical Presentation
Ca Ovary
Stage IIIC
Clinical History
Primary cytoreduction done 4 yrs back.
6 #CT – PACLI-CARBO, counselled but PARPi not available hence didn't go for germline testing.
Patient was monitored with CTC test.
Test Result
2 CTCs were found during monitoring which indicated recurrence • PET CT showed recurrence.
Recurrence in liver, hence surgery repeated.
Lipodox –Carbo x 6 #. Patient was found to be BRCA+. Patient was put on Rucaparib (8 months).
CTC is 0 on follow up.
Clinical Outcome
Case Study 07Patient Details
Male
33 years
Clinical Presentation
Sigmoid colon with peritoneal metastasis
Clinical History
FOLFOX x 4 # - very good partial response.
SX--HIPEC
FOLFOX X8 # +Bevacizumab maintenance
Patient was monitored with CTC test.
Test Result
1 CTC was found in CTC Cluster form indicating aggressive residual disease.
Recurrence in liver found by PET Scan.
Patient succumbed to disease.
Clinical Outcome
Case Study 08Patient Details
Female
45 years
Clinical Presentation
Ca Breast TNBC
Clinical History
RT.MRM -pT= 4.5 cm,N0. BRCA +ve
4# AC-T x 4#-XRT to CW/SCF.
1 yr of capecitabine (low dose)
Patient was monitored with CTC test.
Test Result
Longitudinal monitoring by CTC test shows absence of CTCs.
Patient on clinical follow up
Clinical Outcome
Case Study 09Patient Details
Female
68 years
Clinical Presentation
Ca Breast
pT2N2M0 ,ER+/PR+/HER2+(fish negative)
Clinical History
Acx 4- Taxanes x 12 –XRT to CW/SCF.
Patient monitored with CTC test.
Test Result
After initial treatment, 2 CTCs with 1 CTC Cluster was found.
Treatment was changed to capecitabine + hormonal therapy.
Longitudinal monitoring by CTC test shows absence of CTCs.
Clinical Outcome
Case Study 10Patient Details
Male
55 years
Clinical Presentation
Ca Colon with solitary liver mets.
Clinical History
NACT- folfirinox x 4#
SX for colon and liver
Adj . FOLFOX X 8#.
Patient monitored with CTC test.
Test Result
Latest CTC test shows, 2 CTCs.
However, both PET and MRI are negative.
There is discordance between CTC and imaging techniques.
Patient on follow up. CTC may be repeated in 3 months.
Clinical Outcome
Case Study 11Patient Details
Female
50 years
Clinical Presentation
Ca Ovary Stage IIIC
Clinical History
Primary cytoreduction
6# pacli- carbo
Test Result
2 CTCs were found indicating residual disease.
PET Scan confirmed local recurrence.
Patient was put on Oral Metronomic Chemotherapy (OMCT)
Clinical Outcome
Case Study 12Patient Details
Female
50 years
Clinical Presentation
Ca Breast – RT MRM done
p/w sternal mets and ipsilateral SC LN mets
Clinical History
No chemo/RT/HT taken due to fear
Chemo- AC x 6# - XRT to sternal including Supraclav field
Hormonal therapy x 10 yrs
Test Result
0 CTC were found.
PET Scan confirmed normal
Patient on normal follow up.
Clinical Outcome
Case Study 13Patient Details
Male
55 years
Clinical Presentation
Ca Breast TNBC
Clinical History
MRM- XRT to CW /SCF
NACT – 4 #AC – Pacli- carbo X 12 #
Capecitabine x 1year
Test Result
From 2 CTCs (1 Cluster) during baseline, CTC first monitoring showed progress with 0 CTCs.
However, latest CTC test shows 1 CTC.
However, both PET and MRI are negative.
Early signs of possible drug resistance. Patient on follow up.
Clinical Outcome
Case Study 14Patient Details
Female
19 years
Clinical Presentation
Ca Colon
Clinical History
Stage pT4N2
Capox x 8#
Test Result
4 CTCs were found indicating aggressive residual disease.
Recurrence in liver found by PET Scan.
Patient succumbed to disease.
Clinical Outcome