Dr. Sue Criswell-Hudak, an immunologist who did early work on dendritic cells, has followed the development of immunotherapy for cancer with keen professional interest.
When she herself developed a rare form of cancer—primary peritoneal adenocarcinoma—she determined that immunotherapy would give her the best chance of maintaining a decent quality of life for the longest possible time. “As soon as I got over the initial shock,” she said, “I knew that I had to preserve my own tumor cells so I could take advantage of what immunotherapy can offer.”
Tumor storage is a commercial service still in its infancy, but may soon play an essential role in cancer therapy as new treatments are researched and developed. Immunotherapy, genetic sequencing, some biomarker testing, drug and chemotherapy sensitivity testing, and stem cell therapies all require living cells from the patient’s own tumor so that personalized treatment can be designed.1
Typically, when a patient with cancer undergoes surgery, a small section of the tumor is sent to the pathology laboratory where it is fixed in paraffin, used for diagnostic testing, and then discarded. Therefore, no tumor cells remain that can be used to test targeted treatments in the future if the patient does not respond to standard therapy, develops resistance to chemotherapy agents, or experiences recurrence. By contrast, if tumor cells are preserved during surgery and stored appropriately, they belong to the patient and can be used to select a therapy that is more advance and can offer a better chance of clinical benefit.
“Storing tumor cells is like an insurance policy for the patient,” said Michel Sadaka, CEO of Store My Tumor, Inc., a start-up company that stores tumors in multiple formats. “Every tumor is unique, and storing tumor cells enables the opportunity to determine which treatment has the best chance of success against that particular tumor.”
The most common use for stored tumors thus far, according to Sadaka, is to determine patients’ eligibility for clinical trials of immunotherapy. “A majority of patients do not qualify for inclusion in trials because they have no tumor cells available for testing or have difficulty obtaining tumor cells from the hospital where they were harvested,” he said. “Patients who store their tumors own the cells and can have them sent anywhere for eligibility testing.”
Stored tumors played a key role in determining patients’ eligibility for trials on cancer vaccine therapy and immunotherapy conducted at the University of Pennsylvania, in which the patient’s immune system was “educated” to identify and attack cancer cells.
Thus far, tumor storage has primarily been driven by patients who want access to other treatment options if standard treatment fails, or who anticipate joining a clinical trial. “My oncologists and surgeons were completely unaware of the benefits of storing my tumor,” Dr. Criswell-Hudak said. “It was up to me to do the research and educate them about it.”
To obtain tumor tissue, Store My Tumor provides a kit to the patient, who then delivers it to the surgeon so that cells can be preserved during surgery. Once it is explained that the tumor samples that hospitals store are inadequate for most testing and research purposes, Sadaka said, all but a few providers have been open to the idea.
The cost of tumor storage is not covered by medical insurance, so it will not be an option for many patients who cannot afford it. For those individuals who have adequate resources, however, it may provide access to clinical trials and innovative new treatments that otherwise would not have been possible.
1. StoreMyTumor, Inc. (2013) Store My Tumor Provides New Service for Cancer Patients—Collecting, processing, preserving tumors enables “true” personalized medicine [press release]. http://www.storemytumor.com.