Personalized Cancer Care

Personalized Cancer Testing

This testing, called functional profiling, exposes living cancer cells from individual patients to chemotherapy drugs, targeted agents, and combinations.

The use of this testing enables the patient’s treating physician to prescribe agents with the highest probability of improving the patient’s outcome and minimizing unnecessary toxic therapies.

To find the most effective treatment for you, living tumor cells are collected during biopsy or surgery. The sample is tested outside of your body in a lab, reducing the amount of toxicity your body is exposed to and keeping you as strong as possible to endure the damaging effects of chemotherapy.

An analysis of a sample of your living cancer cells shows which drugs kill the cancer cells (these cells are sensitive to these drugs) and which ones do NOT (these cancer cells are resistant to these drugs). Drug panels are selected for each patient based on diagnosis and treatment history.

The Nagourney Cancer Institute (NCI) will provide a report to help guide treatment options and reduce toxicity exposure. NCI has experienced a very successful rate of positive clinical outcomes.

Click the link below to see an infographic that explains how your cancer is tested.

How Your Cancer Is Tested

5 Questions That Could Save Your Life

What To Ask Your Physician When Diagnosed With Cancer

5 Questions to Ask Your Physician

The use of functional profiling enables the patient's treating physician to prescribe agents with the highest probability of improving the patient's outcome and minimizing unnecessary toxic therapies.

Your testing uses functional profiling. What is it?

Functional profiling is a laboratory technique that measures how cancer cells respond when they are exposed to drugs and drug combinations. Put simply, it is a real-time measure of which drugs cause your cancer cells to die, measured using a process called programmed cell death. By using this approach, we try to determine in the laboratory the best drugs for each patient before they receive them. Click here for more information on functional profiling.
Why do I need to get my cancer cells tested BEFORE I undergo chemotherapy?

Each cancer patient is unique, and responses to therapy are very different from one person to the next. Drugs that work for one patient may not work for another, even if they carry the same diagnosis. This is why each patient should be tested to select the most effective and least toxic drug regimen for them PRIOR to initiating treatment. When patients are treated without testing, treating physicians must rely on general guidelines and protocols that cannot capture each patient's unique features. Standardized trial-and-error approaches cannot provide individualized treatment to meets each patient's needs.
How can your test lower the toxicity of my chemotherapy treatment?

All chemotherapy treatments have toxicities, some more than others. The role of the laboratory is to ensure that the most effective, least toxic treatments are selected the first time. This improves the likelihood of disease response and can help patients to avoid toxic treatment choices when other, milder drug combinations could be effective.
How long does your test take?

Results are available within 7 days of receipt of your sample.
Do you test cancers of the blood such as leukemias, lymphomas, or myelomas?"

Yes. Leukemias, lymphomas, and myelomas are excellent candidates for drug selection, because these cancer cells are easy to obtain (blood tubes, in many cases) and there are many good treatment choices to select from. So long as there are enough cancer cells in circulation or in the bone marrow (generally 30% or more), our testing can offer great opportunities to select active drugs. Some of our earliest work was conducted on these very diseases.
Can you test cancer fluids?

Yes, absolutely. Patients with fluid accumulations in the lungs (pleural effusion) or abdomen (ascites) can have samples extracted and sent in the glass containers used by their general practitioner. Just have your doctor add heparin so the fluid doesn't form a clot. These fluid samples can be effective sources of cancer cells and are generally easy to obtain.
How much of a cancer specimen do you need?

For solid tumors like lung, breast, colon, ovary, etc. tumors, we request a cubic centimeter (about 1 gram) of tissue. Specimen can come from the tumor itself or from distant (metastatic) sites, including lymph nodes. The larger the sample we receive, the more drugs and combinations we can test. Biopsies sometimes contain necrotic (dead) tissue, fat, and non-cancerous cells, so the more we get, the better. For cancerous fluids (pleural or ascites), we request 500 to 1000 ml of fluid but can sometimes work with less. Again, fluids must have heparin added to avoid clot formation. For blood-borne cancers, we require at least 10 to 20 ml of blood, or at least 1 to 3 ml of bone marrow. Note: Solid tumor -needle biopsies- usually do NOT contain enough cancer cells for our purposes, and we do not encourage them unless pre-arranged with our physicians.
I'm just starting chemotherapy. Can I still get my cancer tested?

Patients on active chemotherapy must wait until the effects of their current drugs wear off (generally 2 to 3 weeks). This is because the drugs administered can have an effect on the health of the cancer cells, even if the drugs aren't working very well. To avoid acquiring damaged cells that may yield laboratory results, we always wait 2 to 3 weeks before testing.
I don't live in the Long Beach, California area - Can you still help me?"

Yes, we can arrange to have your sample collected where you live and shipped overnight to our laboratory in Long Beach, CA. Our lab receives samples from all over the US and from international locations. Contact us and we will be happy to provide you with a specimen transportation kit and specific handling instructions. Click here to learn more about consultations and personal cancer testing.
Are your tests the same as the gene test offered by other institutions?

No, and this is a critical point. The tests offered by most medical centers are known as genomic analyses. These use the patient's DNA to look for mutations and other changes in each patient's gene makeup that might guide drug selection. While this concept is appealing, in reality, a minority of patients have genetic changes that can be used for therapy. Indeed, several clinical trials have failed to show meaningful benefit for patients with advanced cancer who received genomic-test selected drugs, except for a very small number of well-established targets like HER2 in breast, BCR-abl in leukemia, and EGFr and ALK in lung. This reflects the extremely complex nature of human cancer. Genes are only the beginning of the long process of cancer development. Each human cancer reflects all of its genes, both mutated and normal, acting together to create what we recognize as a malignant tumor. Only functional analysis can capture each patient's tumor in real time and provide insights that can inform drug selection and treatment decisions. Click here to learn more about functional profiling.
Why do you test live cancer cells in your laboratory?

Cancers arise from cells that have learned certain tricks to enhance their survival, enabling them to outlive their normal counterparts - (this is the subject of Dr. Nagourney's book Outliving Cancer, available on Amazon). These transformed (cancerous) cells interact directly with their micro-environment. Cancer cells "talk" to each other and to all their surrounding cells using chemical signals like growth factors and by-products of metabolism. Blood vessels, immune cells, and connective tissues (stroma) all participate and contribute to the cancer development process. This is why it is absolutely essential to test cancers in their own natural clusters, known as microspheroids. We isolate these 3-dimensional structures from each patient's tumor to test drugs and combinations. We capture cancer in its native state, which is what make our approach the most accurate platform for response prediction. Click here for more information on Dr. Nagourney's book.
I don't have an oncologist. What can I do?

Our job is to assist every patient to be sure that they receive the most effective, least toxic drug combinations available. We work with oncologists all over the world to see that this is accomplished. If you do not have an oncologist or your doctors will not work with you to achieve this goal, Dr. Nagourney, who is triple board certified in Internal Medicine, Hematology, and Oncology and is a practicing clinical oncologist in Southern California, will see that you get the right treatment the first time and every time.