Case Studies

The following are short overviews of some notable recent cases that exemplify our approach.

  • Case Study 1: A male in his 60s with metastatic Non-Small Cell Lung Carcinoma (NSCLC) came to us while partially responding to Avastin. Our analysis suggested that his cancer was driven by two primary pathways: VEGF and PDGF. VEGF is Avastin’s target, which explained the partial response: PDGF was left unaddressed. This suggests that Sutent (that targets both pathways) may be suitable alone or in combination with the Avastin, or Gleevec (which targets PDGF) may be suitable to add Avasin. Interestingly, while the data showed a substantial dysregulation of EGFR itself, our analysis concluded that this was not the driving force behind his cancer because there was minimal activity in the rest of the pathway. After presenting this information to the oncologist, we learned that the patient had failed Tarceva (a drug that targets EGFR) despite having an EGFR mutation and KRAS wild-type – the personalized medicine “gold standard” that predicts a positive response to Tarceva.
  • Case Study 2: A female in her thirties had pancreatic cancer. Through our studies of the profile of her tumor, we found evidence that inhibition of a specific genetic pathway, the mTOR pathway via compounds like rapamycin or Afinitor, may be relevant to this particular cancer. The literature revealed a clinical trial of rapamycin in pancreatic cancer that failed, however, it also showed two successful case studies where rapamycin was used in combination with Gemcitabine or Capcitabine in pancreatic cancer.
  • Case Study 3: A male in his 50s was diagnosed with metastatic melanoma. When we examined his tumor, we found two distinct actionable hypotheses. The scientifically stronger one was based on an upregulation of the CDK-2 pathway (combined with a deletion of a gene that inhibits CDK-2, PKC-eta), suggesting a investigational drug (Flavopiridol) that was accruing for a Phase II trial in melanoma. A somewhat weaker hypothesis (fewer corroborating pieces of evidence) was for the SRC and the LCK pathway, which suggested dasatanib – an FDA-approved agent that targets both. The patient is currently responding well to his existing therapy, but these approaches remain as a “plan B” in the event of failure.


Please contact us to learn more about CollabRx ONE personalized research services.