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| Note from the founder and CEO: |
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| Cancer therapy is poorly tailored to individual patients. For that matter, so are psychiatric therapies, neurologic therapies, and many other therapies in many other medical disciplines. |
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| While randomized trials have demonstrated that adjuvant chemotherapy improves the chance of long-term survival for patients with a multitude of solid malignancies, for example, a multi-cycle chemotherapy regimen often improves the chance of long-term survival by only 3-15 %. However, a 5 % improvement in the odds of long-term survival means that for every 100 patients treated, 5 benefit. Some of the other 95 would have been cured with surgery alone (without the addition of chemotherapy), while the remaining patients will not be cured despite receiving chemotherapy. All 100 patients, of course, undergo the toxicity and expense. |
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| As another example, localized prostate cancer patients undergoing radiation therapy often receive approximately 81 Gy in 45 fractions, given via intensity modulated and image-guided techniques, to the entire prostate (and by necessity, the prostate-rectal and prostate-bladder interfaces). If the greatest tumor burden is localized to the posterior prostate, the prostate-bladder interface still receives full dose. If the bulk of the tumor is located in the anterior prostate, the prostate-rectal interface still receives full dose. If the tumor is radiosensitive, all 45 fractions are still delivered. If the tumor is radioresistant, the prostate still receives only 81 Gy. And so on. Doses and targets are not customized to the individual patient, and all patients receive the toxicity and potential morbidity associated with radiation therapy to the anterior rectum and the posterior bladder. |
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| At ImQuant, we believe that the ability to measure how a tumor and its various sub-regions are actually responding to the selected therapy, and to make intra-therapy adjustments based on response measurements and response-based predictions, holds great promise. |
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| We believe that in vivo tumor monitoring, and adjustment in therapy based on treatment-induced tumor changes, represent the future of oncology practice. Initial therapy will be selected based on the results of randomized trials, and/or pharmacogenomically. Treatment will be given with the tumor in tact, such that the tumor can serve as its own in vivo assay. Treatment-induced change, early in therapy, will be detected and measured via molecular and functional imaging. Outcome predictions will be made based on these changes. Mid-course adjustments in treatment will be made based on these predictions. |
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| Until ImQuant developed its patented technology, many
imaging-based limitations remained: |
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Most treatment response estimations are based on changes in tumor dimension or volume. However, changes in tumor physiology and molecular composition are generally ignored. |
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Treatment response estimations incorporating physiologic and molecular changes (via technologies such as MR spectroscopy and FDG-PET) consider such parameters as maximum or average SUV, essentially ignoring the heterogeneity of physiology – and heterogeneity of response – of various tumor sub-regions. Quantifying change within physiologically- or molecularly-distinct tumor sub-regions will make it possible to detect clinically significant areas of slow or absent response, even when the majority of a tumor is responding well to therapy. In addition, by separately quantifying change within sub-regions, it will be possible to define distinct areas within an organ or tumor that warrant the delivery of intensity modulation-based concomitant intra-tumor boost treatment. |
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Treatment response estimations that consider the heterogeneity of response within tumors generally estimate change via the registration of pre-therapy to intra-therapy images (and, for example, voxel-by-voxel digital subtraction). However, voxel-by-voxel registration of a tumor that has changed in size and shape to therapy – and for which different sub-regions of the tumor have changed to different degrees – is impossible. |
ImQuant's patented technologies are about building tools to facilitate the quantification of treatment-induced image change with as much accuracy and detail as possible, and allowing researchers and clinicians to integrate change into the treatment-related decision-making process. ImQuant therefore has two closely-integrated products which are continuously evolving and improving. |
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| We don't pretend to have every problem solved, and are very open to dialogue and collaboration |
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| Sincerely, |
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| Timothy E. Sawyer, M.D. |
| Founder and President, ImQuant, Inc. |
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