Onconomics RGCC

Purpose of the test

The Onconomics test looks for the effectiveness (chemosensitivity) of specific anti-cancer drugs and targeted therapies – called monoclonal antibodies (MAbs) and tyrosine kinase inhibitors (TKIs) – on a single patient.

What is chemosensitivity testing?

These tests combine molecular and cellular approaches and are designed to identify specific anti-cancer drugs. The results of the tests need to be validated, using assays.

What are gene expression profile viability assays?

We use these tests to confirm the viability of the cells that are exposed to the drugs that are being tested. This diagram shows the proportion of healthy cells, in comparison with the primary population, that respond to a cytotoxic drug. A cytotoxic drug is one that has the ability to destroy living cells.

Cutoff points:

• Over 80% cytotoxicity: The drug targets more than 80% of living cells in the sample, therefore it shows sensitivity
• Between 35% and 80%: The drug targets 35-80% of living cells in the sample, therefore it shows moderate sensitivity
• Below 35%: The drug targeted less than 35% of living cells in the sample, therefore the substance is ineffective. This is known as resistance.

Useful information

The Onconomics test requires 15-25 ml of whole (peripheral) blood, to be sent in a liquid preservative in a 50ml volume Falcon tube. Tissue samples require a minimum of 400mg, sent in the vial provided.

Support and training

RGCC provides phone and online support on how to conduct the test and interpret the results. We also provide regular training courses for clinicians in order to familiarise them with the tests.

RGCC will provide you with a transportation container with the following:

1. Two vials for blood samples (note you only need one, another is provided in case)
2. Vials for tissue samples (available upon request)
3. A cooling bag containing an ice pack
4. A medical form
5. Documents required to transport biological samples.

The blood sample vials should be stored in the fridge. The ice pack should be kept in a freezer for at least 24 hours before it is used.

If you wish to send a tissue sample please place it in the vial. We require a minimum of 400mg to conduct the test. If you are sending a blood sample, we require 15-25ml of venous blood. Please discard the first 5ml of blood collected, to reduce the likelihood of contamination.

As soon as the blood sample is taken, place it in the vial, then close the top and roll it gently. Place the vial inside the transportation container. Please ensure that the medical form is completed, signed by a doctor and the patient and enclosed in the package.

How to send your samples to RGCC

Step 1 – Arranging courier collection

Please give us 1-2 days’ notice of the shipment date in order to arrange collection. We will need the following details to arrange collection: your full postal address, including postal or zip code, a contact telephone number and a named contact to pass to the courier.

We usually suggest you do these tests in the morning to allow time for the courier to collect the samples. Please bear in mind that the courier will contact you to inform you of the time of their last daily collection.

The courier we use is DHL Express. If you do not wish to use our courier, please contact us for our courier account number. You will need to supply this to the courier company, so the shipping fees can be charged to RGCC.

Step 2 – Complete paperwork

Complete all the necessary courier documents:

1. A UN3373 biological substance category B commercial invoice (non-European countries only);
2. Enter the description of the shipment as ‘biological substance category B, UN3373’, and record the total value of the shipment as US$1;
3. Please be sure that the label ‘UN3373 diagnostic specimen’ is on the outer wall of the container. These labels are included in the transportation container provided by RGCC;
4. Once the package has been collected by a courier, please email us to inform us that your sample is on its way.

The paperwork will be sent to you once your transportation container is dispatched.

What else is important to know?

The way genes are expressed is not always the same as the rate proteins are expressed, because of a variety of processes that go on within cells. For a drug to have an effect it needs to pass through a permeable membrane and into cells. In order to confirm the information that the test generates, the cancer cells are exposed to the active substance of each drug and we explore if the drug has the ability to destroy viable cancer cells.