The most comprehensive tumour investigation

exacta is a comprehensive analysis of molecular-genetic characteristics of solid tumours based on the results of several clinical studies.

exacta proves particularly advantageous in cases of rare solid tumours for which no guidelines exist, in advanced stages, or in tumours that are difficult to treat. exacta analyses millions of data points at the molecular level to identify all relevant targets for targeted therapy.

 

About exacta

Every human being is different and unique, similarly every person’s cancer is unique.
Therefore, cancer should ideally be treated with a personalised strategy. Conventional ‘Standard of Care’ approaches do not take into consideration the molecular-genetic architecture of a particular patient‘s tumour. Consequently, patients could suffer due to failed therapies or aggressive relapse. It is imperative that the molecular architecture of the tumour is studied comprehensively before deciding on the treatment plan. The therapy can thus be tailored to the individual patient and their disease. This significantly increases the likelihood of successful treatment.

exacta helps to reveal clinically relevant driver mutations and pathways. This is ensured by the use of a variety of biomarkers and the analysis of 20,800 genes in the tumour.
exacta identifies the most effective chemotherapeutic agents and targeted therapies.
exacta enables a highly sophisticated treatment strategy beyond conventional perspective, even for difficult to treat or late stage cancers.

exacta is particularly recommended for cancer patients where ...

... first-line therapy has failed.

... cancer has relapsed.

... cancer is high-grade / metastatic.

... challenging cancers such as stomach, oesophagus, pancreas, gall bladder, GIST etc. have been newly diagnosed.

... risk of therapy failure is high.

Methodology

  • Targeted Genes

    Tissue DNA and ctDNA:
    SNVs, CNVs, gene amplifications, mutational burden, germline mutations

  • Immunocytochemical analysis

    CTC:
    mTOR, VEGFR1, VEGFR2, EGFR, VEGFA

  • mRNA sequencing

    Tissue or exosomes:
    Signalling pathways, transcriptome (disease-related, therapy-relevant and resistance patterns)

  • Pharmacogenetics

    Genotyping, including for CYP450, transporter proteins for assessment of drug toxicity and efficacy

  • Chemoresistance profile

    CTC:
    Patented in vitro cell based assay on living cells to assess the effectiveness of chemotherapeutic agents

  • Immunohistochemistry

    Tissue:
    PDL1, AR and if applicable, ER/ PR /HER2

Advantages

Most Optimal Targeted Therapy Selection:
• exacta identifies possible molecular targets and cell cycle pathways to find the most appropriate molecular targets for targeted treatment.
• All relevant biomarkers for targeted therapy selection, including mutations, deletions, gene rearrangement, gene amplification / expression, are analysed.

Assessment of adverse drug reactions:
• Selection of therapy with least side effects based on pharmacogenomics.

Most Optimal Cytotoxic Therapy Selection:
• Cytotoxic drug response / resistance of cancer genome, based on DNA and gene expression.
• Analysis of the effectiveness of chemotherapeutic agents and, upon request, other active substances on living tumour cells.

Comprehensive

Parameters and Methods of Analysis
  • Tumour DNA analysis
    511 genes (tissue biopsy) / 411 genes (liquid biopsy)
  • Mutations and gene amplifications
  • Fusion / rearrangements

    51 genes (tissue biopsy)
    12 genes (liquid biopsy)

  • Tumour gene expression

    approx. 20.800 genes

  • Cellular pathways as per KEGG
  • Chemoresistance profile (Chemotherapeutic agents + complementary substances)

    up to 70 substances

  • Liquid biopsy cell free DNA (cfDNA)
  • ICC immunocytochemistry (mTOR, VEGFR, EGFR, etc.)
  • Microsatellite instability (MSI / MMR)

    (tissue biopsy / liquid biopsy)

  • Tumour mutational burden (TMB)
  • Relevant IHC, PD-L1, AR etc.

    (tissue biopsy)

  • Circulating tumor cells (CTCs)
  • Pharmacogenetics
  • Limit of detection (MAF)

    0.1 % (cfTNA)

  • Sensitivity at 0.1 % MAF (cfTNA)

    97.06 %

  • Positive Predictive Value

    100 %

* Subject to availability of adequate sample.

Comparison chart exacta / exacta Basic

At Exacta, it is generally possible to submit either blood samples alone or a combination of blood and tissue samples. However, we recommend, whenever possible, including tissue samples (no more than 12 months old). Additionally, the test scope for Exacta Basic has been adjusted: for instance, transcriptome analysis is omitted if it is not clinically relevant or if a pharmacogenetic analysis has already been performed.

 

View comparison (PDF)

Sample requirement

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40 ml blood in STRECK and EDTA tubes

Optional: 40 ml blood in STRECK and EDTA tubes as well as FFPE tissue block with sufficient amount of tumour content

Turn Around Time (TAT): 12 - 14 working days from receipt of the sample in our laboratory

FAQ

Can a patient’s exacta result be used for another patient with the same diagnosis?

Just as every patient is unique, so is every cancer. No two patients’ cancers are alike. Even two similar patients (e.g. age, gender, height, lifestyle) with the same type of cancer will have different molecular tumour profiles. Hence, each patient should perform an individual exacta test.

Why is it important to start treatment immediately?

Cancer can be very aggressive and may evolve rapidly; the tumour profile can change dramatically over time. If there is a long enough delay the cancer may gain resistance to treatments and re-analysis may be required. With exacta, therapy can be adapted quickly.

What kind of drugs will be recommended to the patient?

Only drugs that have been approved by the FDA will be recommended and be administered. exacta will distinguish in its report clearly between on-/off-label drugs based on the individual cancer disease. Complementary substances can be tested as an additional option.

Are there any follow-up molecular tests to assess the result of recommended therapy?

Molecular tests like our cancertrack analysis allow the oncologist to monitor the therapy in real time. In addition, the test provides insights on genetic changes of the original tumour to adapt the therapy.