Testing for efficacy

As described elsewhere on this website, any cancer therapy will, at best, only work for a subset of patients.

Cancer is a highly variable disease; each patient’s cancer will have a unique genetic make-up which will also continue to evolve. A therapy therefore only works if it "matches” a patient’s cancer biology in the intended manner and until resistant cells have evolved. 

Personalised medicine
Increasingly, diagnostic tests are being used to select those patients who are most likely to respond to a potential therapy and/or deselect those who are not. This is done to maximise chances of success and to avoid unnecessary but potentially toxic treatment and its associated costs.

However, such tests are proving challenging to develop and currently the most informative tests are based on the analysis of single genes with a very strong impact on a cancer's biology. Important examples are tests for rare specific gene-fusions for which targeted therapies have been developed. 

Tests for bacterial immunotherapy

It is relatively well understoond which immune cells are involved in a tumor specific immune response and, therefore, the presence or absence of which categories of immune cells determine whether a tumour specific immune response can occur. Since it will take a number of days for an immune response to bacterial immunotherapy to occur, it is likely that meaningful tests to discriminate responders from non-responders will be possible on patients that have received a first dose.