What is the Personal Discovery Process (PDP)?
The Personal Discovery Process provides individuals with treatment-driven research on an unprecedented scale. PDP is effectively a massive clinical trial for a single patient. We engineer the genetic complexity of each patient’s unique tumour network into an army of 400,000 fruit fly "avatars.” Using robotics, we evaluate up to 2,000 FDA approved drugs including non-cancer drugs, to identify drug combinations that significantly improve mortality in the individual’s avatar population.
The PDP methods are licensed exclusively to My Personal Therapeutics (trading as Vivan Therapeutics)
What role does my oncologist play?
The PDP process begins and ends with your oncologist.
We start by having a conversation with you and your oncologist to learn about your cancer and prognosis. Tailored treatment recommendations detailed in your Screening Report and ranked by efficiency are reviewed by your oncologist and tumour board who then decide which drug combination may be right for you. We work with your oncologist and provide post- PDP support for interpreting results and analysing optimal treatment recommendations.
How does PDP compare to targeted therapies?
Targeted therapies are designed to specifically hit target mutations present in the patient’s tumour and as such represent an improvement of traditional chemotherapy. This approach would work well in cases where a single actionable target gene is identified (e.g. BRAF), for which a drug has been developed (e.g. VEMURAF).
However, almost every tumour will show several actionable mutated genes, e.g. BRAF + APC + EGFR + PTEN. Taking one drug for every target is not possible because of the high toxicity produced by the combination of anti-cancer drugs. Thus, the oncologist is forced to choose from one of these mutations and select a targeted therapy based on partial genetic information, leading to failed treatments and tumour resistance.
PDP can introduce up to 20 cancer associated mutations per avatar and find the drug cocktails that target the oncogenic network created by them. Thus, the treatment recommendation is developed based on a comprehensive mutational cancer landscape.
Who can benefit from PDP?
PDP can be employed for patients with gastro-intestinal (GI) cancers, including tumours of the upper (e.g. oesophagus) and lower (e.g. colorectal) GI tract, as well as for patients with lung cancers. Patients with rare cancers or tumours of unknown origin for which no standard protocol has been established could also greatly benefit from PDP.
PDP can help identify optimal treatments for patients with early cancers as well as for patients with difficult to treat advanced cancers, who have exhausted treatment options with conventional approaches.
Finally, people with pre-malignant gut lesions can also benefit from PDP. The presence of adenomas in the digestive tract is well correlated with the development of a colorectal cancer in the following years. Non cancer patients with this feature can greatly benefit from having a pre-avatar model already built and ready to provide a treatment recommendation when required.
Please get in touch to find out if your specific cancer can benefit from PDP.
What is the rationale for using flies to find the most appropriate personalised therapy?
Drosophila (fruit fly) is the most flexible genetic model organism. The unique genetic toolkit available in flies enables us to introduce up to 20 gene mutations found in the patient’s tumour, allowing the creation of a fully personalised avatar carrying a tumour “à la carte”. The small size and the short life cycle of these animals permits the fast expansion of the avatar population. In this way, we create and utilise 400K flies (an impossible number for any other animal model) to run a high-throughput drug screening, allowing us to generate powerful pre-clinical statistics for every drug or drug combination tested.
Roughly 75% of human disease-causing genes have a functional counterpart in the fly. Drosophila has been used since the early 1900s to study human diseases, including cancer. The signalling pathways involved in cancer are conserved in fruit flies and in fact many components of these signalling pathways were first discovered in the fly.
What is the evidence that PDP works?
The PDP process is one of the most recent innovations in personalised cancer care. The technology underlying PDP was developed by scientists at the Icahn School of Medicine, Mount Sinai (New York), and is backed up by decades of academic cancer research. A case study of a cancer patient receiving a therapy developed by PDP has been recently published (Bangi et al, 2019, Science Adv., doi: 10.1126/sciadv.aav6528). https://advances.sciencemag.org/content/5/5/eaav6528
Why is PDP better than other personalised options?
PDP is the world’s only strategy using real patients’ avatars for drug screenings. Genetic mouse avatars cannot be created due to lack of sophisticated genetic tools - only two or three mutations could be introduced in mice, not comparable to the 20 mutations included in the PDP model.
Related options include patient-derived xenograft (PDX) mice and organoids. Although initially promising, the implementation of PDX mice for the identification of personalised treatments has been halted due to lack of success and cost constraints, and they are currently used for academic research only.
Cell-based strategies such as organoids built from a patient’s cancer cells are available. However, organoids can be obtained for only a fraction of patients and they are used to test standard of care medicines. Moreover, as these cancer cells are artificially cultured, they lack realistic drug responses because they are acting in an in vitro artificial environment.
Therefore, Vivan’s technology is positioned at the forefront of personalised medicine.
How long does PDP take?
PDP can take 4 - 5 months after tumour and blood sequencing results are available. The difference in time reflects differences in tumour type, complexity, the number of drugs and drug combinations tested until the final cocktail is identified.
What information will I receive?
Vivan will produce two reports: An early report with DNA sequencing results, which will help you decide on the first line of treatment while PDP is in progress and a final full report detailing the best tailored treatment recommendations for your patient, ranked by efficiency. Vivan’s scientific team will also give you post- PDP support for interpreting results and analysing optimal treatment recommendations.
How can I keep track of test results and the PDP journey?
The Vivan scientific team maintains contact with patients and oncologists to keep them informed throughout the Personal Discovery Process. In addition to this, once registered, patients receive access to a patient app and oncologists to an oncology portal in order to keep track of all progress made throughout the Personal Discovery Process.