Research
Gene Expression (molecular) Profiling
Rather like Betamax versus VHS in the early days of videos there are different technologies to profiling DNA or RNA from a biopsy sample in order to try and characterise the cancer: Complementary DNA (cDNA) Micro-Array and Reverse Transcription-Polymerase Chain Reaction (RT-PCR).
CupPrint uses cDNA Microarray (which we tried for Jo) uses a "nearest neighbour" identification system. The test measures 495 genes and compares the patient's sample with a reference database of the gene expression profile of 79 known cancers to build a genetic protrait of the cancer. The laboratory test for CupPrint is run in Amersdam and Phoenix , Arizona.
This is a fast-moving area of research and development with some tests commercially available and some still under development. The latest information we have is drawn from Ross, J.S. & Mazumder, A. Tissue microarrays & gene chips in Wick, Mark. R (ed) (2008) Metastatic carcinomas of unknown origin. NY: Demos medical publishing. In addition to CupPrint they list 2 other testing organisations with different methodologies:
Molecular Identification Cancer Test (MCID) by AviaraDx of Carlsbad, California and Pathwork Tissue of Origin Test by Pathwork Diagnostics of Sunnyvale, California.
In addition they show Gene Search by Veridex,LLC of Warren, New Jersey which is not yet on the commercial market.
Information concerned with the NHS
Duties of a Primary Care Trust (PCT). This link is to the Harris Report (forwarded by Sarcoma UK) and is a useful source for anyone considering a PCT appeal for treatment which has been refused. The Harris Report was commissioned by NHS London. The author is one of its own team who is both a doctor and a lawyer - Dr Andrew Harris. He gives a very full picture in legal terms of the duties of a PCT. Dr Harris claims copyright on the front cover but the report has been supplied through Freedom of Information by his employer without any noted restrictions and therefore can be regarded as in the public domain.
www.sarcomauk.org/docs/the_harris_report.pdf
Top-up payments. Some patients have been able to “top-up” their NHS care and some have not. Patients in identical situations have access to different types of drugs depending on the area of the country in which they live.The Department of Health has said that patients should not be able to “top-up”. A group of doctors seeks to challenge the situation arguing that such payments should be allowed under the current law.
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