SERVICES AND TESTS AVAILABLE

○ We provide a variety of genomic tumour-based tests and Liquid Biopsy

○ We conduct hereditary genetic testing and counselling

○ We support intraoperative chemotherapy include HIPEC, Isolated limb perfusion

○ We provide individualised assessment of cancer recurrence risk based on genomic markers including OncotypeDx for breast cancer, and HalioDx Immunescore for colon cancers

HIPEC or Hyperthermic Intraoperative Peritoneal Chemotherapy is a process of administering chemotherapy intraoperatively to treat cancer that have spread to the lining of the abdominal cavity. It is the treatment of choice for chemoresistant tumours in particular low grade mucinous cancers of the appendix and ovary. HIPEC directly exposes the peritoneal surface to chemotherapy, and can achieve chemotherapy dose exposure concentrations many fold higher than what can be achieve via intravenous infusion. Our groups works with experienced peritoneal surgeons and have supported more than100 HIPEC procedures.

Signatera is an ultra-sensitive circulating tumour DNA test, that is designed to detect extremely minute evidence of residual cancer in the body. This test involves next-generation sequencing of your tumour tissue, and assembly of personalised markers unique to your tumour, followed by a very deep and sophisticated search for the tumour DNA in your blood. The knowledge of molecular “residual disease” can make an important difference in guiding treatment in some patients. The test is currently assigned “breakthrough designation” status with the US FDA, and is expected to be approved in the coming months. It is currently available under “research” status.

Accurate diagnosis of tumours is the foundation of all cancer therapy. Understanding a tumour’s precise molecular alterations will allow for very focused targeting of tumour using “targeted” anti-cancer drugs. Up to recently, this biopsy of tumour tissue, typically involved inserting a large needle into the tumour to extract cancer cells. Guardant Liquid biopsy is an extremely sophisticated blood test that allows your doctor to initially avoid tumour needle biopsy, focusing instead on the detection minute amounts of tumour DNA in your bloodstream. This avoids the complication of biopsy – which includes pain, bleeding and air-leak. Liquid biopsies can allow for the longitudinal tracking of tumour mutations – clonal and sub-clonal – as the cancer evolves and responds to treatment.

PARP inhibitors have been labelled as one of the biggest breakthough for medicine and oncology. myChoice CDx tumour testing, allows for the precise selection of patients likely to benefit from PARP inhibitors.  Comprising of a composite score of Loss of Heterozygosity (LOH), Telomeric Allelic Imbalance (TAI), and Large-scale State Transitions (LST) – using DNA isolated from tumour tissue. The results of this test are used as an aid in identifying patient with ovarian, prostate and pancreas cancers who are positive for homologous recombination deficiency (HRD) and likely to benefit from PARP inhibitors.

Lucence tests support cancer diagnosis, treatment selection, and disease monitoring for improved cancer care. Through identifying clinically-relevant mutations that are driving the growth of each patient’s unique cancer, physicians can better understand the disease for improved management. Additionally, Lucence blood tests can also identify patients who have inherited cancers for matching to appropriate targeted therapy and future risk management.

FoundationOne CDx is a FDA-approved broad companion diagnostic (CDx) that is clinically and analytically validated for solid tumors. The test provides next-generation DNA sequencing analysis of patient’s tumor to provide physicians with clinically actionable information — both to consider appropriate therapies for patients and understand results with evidence of resistance. Microsatellite instability (MSI) and tumor mutational burden (TMB) is included in every test and can help inform immunotherapy decisions. You can also order PD-L1 immunohistochemistry (IHC) testing to help inform your therapy decision.

TEMPUS is a test that is able to perform DNA, RNA and whole exome sequencing of a patient’s tumor It may potentially provide actionable genetic information to physicians who can then further personalize a patient’s cancer treatment. Each test includes microsatellite instability ( MSI)status and tumor mutational burden (TMB) which a clinically relevant.

This medical grade blood test evaluates up to 84 genes associated with hereditary cancers including breast and gynecologic, gastrointestinal, endocrine, genitourinary, skin, brain/nervous system, and sarcoma. Pre and Post Test counselling will be provided – and patients who test positive for genetic diseases will be referred onto a program for screening and early cancer detection.

There are many forms of loco-regional therapies used as part of the arsenal against cancer to provide better control of tumors in the liver. Radiofrequency ablation (RFA)and microwave ablation (MWA) use imaging to direct a needle into a tumor target and then use heat to destroy the tumor with either electric current or microwaves. These techniques are particularly good for small tumors in the liver – but can be also used for tumours in the lung, kidney and bone.

Transarterial chemo-embolization (TACE) involves the administration of cytotoxic chemotherapy directly into the liver tumor via blood vessels. It is useful for delivering higher local doses of chemotherapy directly into the tumour, with less whole-body (systemic) chemotherapy side effects. It is often used in primary liver cancers.

Selective internal radiation therapy (SIRT) or trans-arterial radioembolization (TARE) is a technique where tiny radioactive beads (microspheres embedded with Ytrium-90) , instead of chemotherapy, are directed to liver tumors through the blood vessels, allowing for more targeted treatment of tumors.

Stereotactic body radiation therapy (SBRT) differs from conventional radiation therapy in allowing the radiation oncologist the ability to deliver a higher dose of radiation over a shorter period of time with less collateral damage. It is most often used in cancers like prostate and liver.

Chemotherapy does not automatically mean you will have hair loss.  Scalp cooling with a cold cap device has been shown to be effective in preventing chemotherapy induced hair loss.  Results are best with chemotherapy regimens such as weekly Paclitaxel.  Scalp cooling reduces scalp temperature to approximately 14 degrees centigrade during your chemotherapy infusion.  In many patients, cooling the scalp to 14 degrees is sufficient to prevent hair loss.

OncotypeDx helps select women who will benefit from chemotherapy.  It identifies women with hormone-responsive breast cancer who have very good outcomes with hormonal therapy, who do not need chemotherapy.  Using gene expression profiling, it analyzes a sample of the tumour (removed during a biopsy or surgery) for a group of 21 cancer-related genes that predict the behaviour of cancer, it’s potential to recur, and responsiveness to hormonal treatment.  Oncotype Dx can also be used to determine the risk of recurrence in DCIS (ductal carcinoma in situ) as well as the likelihood of the benefit of radiation therapy after DCIS surgery.

Leutetium-PMSA is a type of targeted therapy that delivers radiation to prostate cancer sparing normal healthy cells.  It works by combining radioactive particles to a “homing” protein, the seeks out prostate cancer cells.   When the medication is injected into the bloodstream, this medication will travel to the prostate cancer cells wherever they may be in the body, and deliver a high dose of radiation.

Leutetium-DOTATATE is a form of radioactive targeting therapy that combines DOTATATE, a somatostatin analogue and the radionuclide is Leutetium-177.  When the medication is infected into the blood stream, the drug homes in to the neuroendocrine tumor and upon binding to the cancer cell, the leutetium177 will release radiation to kill the cancer cells.

CARIS Molecular Tumour Profiling is a sophisticated DNA, RNA, Protein and Immune analysis of your tumour. It provides Next-Generation sequencing analysis of more than 700 tumour gene mutations within your tumour, to look for activating gene mutations and RNA fusions that may drive your cancer growth. With this knowledge, doctors can better understand your tumour and select drugs that can specifically target the activated gene drivers of your cancer. CARIS tumour profiling also employs In situ Hybridization to detect gene amplifications, translocations and fusions; PyroSequencing to detect gene methylation and silencing, and Immunohistocytochemistry to determine protein expression. The test also analyses biomarkers that predict response to Immunotherapy – such as PDL1, mismatch repair deficiency (MMRd), and tumour mutational burden (TMB). The test incorporates an Artifical Intelligence Genomic profile similarity score – that may be useful for identifying cancer of unknown primary, and selecting treatment.