As cancer treatment continues to rely on averages and probabilities, a breakthrough approach using live tumor profiling promises to personalise therapy, reduce suffering from ineffective drugs, and significantly improve outcomes for patients facing late-stage disease. The #Newsdesk finds out…

Personalised cancer therapy is transforming oncology as live tumour profiling technologies like the SAGE Oncotest™ enable doctors to predict drug resistance with nearly 80% accuracy. By testing patient-specific tumour responses to FDA-approved therapies, this approach improves treatment outcomes, reduces chemotherapy side effects, and advances precision medicine beyond genetic testing alone.  

For decades, cancer patients and oncologists alike have lived with an uncomfortable truth: even with cutting-edge diagnostics, treatment often remains a gamble. Despite advances in imaging, molecular diagnostics, and genomic sequencing, nearly 70% of late-stage cancer patients do not benefit from the first chemotherapy regimen prescribed under the current standard of care. This sobering statistic stresses a critical gap in modern oncology—the inability to predict, with confidence, which treatment will work for an individual patient. 

Cancer, by its very nature, is deeply personal. No two tumors are identical, yet treatment decisions are frequently guided by population averages rather than individual tumor behaviour. A new approach, SAGE Oncotest™, aims to change that by bringing real-world tumour response into the lab—before treatment begins.

Why Cancer Therapy Is Still Hit or Miss

The current standard of care in oncology is built on decades of clinical trials and evidence-based medicine. It remains indispensable—saving millions of lives worldwide. However, these guidelines are derived from statistical averages. And in cancer, no tumour is average.

Even so-called precision medicine has limitations. Genomic testing, often hailed as a game-changer, identifies actionable mutations in only about one in four patients. For the remaining majority, sequencing offers limited guidance, leaving oncologists to rely on trial-and-error chemotherapy—often at a high physical and emotional cost to patients.

This explains why a therapy that works remarkably well for one patient may be entirely ineffective, or even harmful, for another with the same diagnosis.

It is important to acknowledge that standard-of-care protocols exist for good reason. They are rigorously tested, widely accessible, and provide a crucial framework for treatment decisions. Without them, oncology would descend into guesswork.

Yet their core limitation lies in their design: they assume similarity where there is profound biological diversity. Tumours differ not only between patients, but even within the same tumour mass—exhibiting heterogeneity that standard diagnostics often fail to capture.

This is where functional testing—observing how live cancer tissue responds to drugs—offers a compelling complement to existing approaches.

How the SAGE Oncotest™ Works

Developed by SageMedic, the SAGE Oncotest™ represents a paradigm shift in cancer diagnostics. Instead of predicting drug response based on genetic markers alone, it directly tests how a patient’s living tumour tissue reacts to therapy.

Using a fresh biopsy sample, SageMedic creates multiple three-dimensional microtumor replicas that preserve the tumour’s original microenvironment and cellular diversity. These live microtumors are then exposed to a tumour-specific panel of FDA-approved drugs and combinations aligned with NCCN guidelines.

The test focuses on extreme drug resistance. If tumour tissue remains viable even at high drug concentrations in the lab, it strongly indicates that the therapy will not work in the patient. This information allows oncologists to avoid ineffective treatments, sparing patients unnecessary toxicity, loss of time, and diminished quality of life.

With nearly 80% predictive accuracy, the SAGE Oncotest™ more than doubles a patient’s current chances of receiving the most effective treatment on the first attempt.   

While most therapies tested fall within approved guidelines, there are cases where standard options prove insufficient or uncertain. In such situations, the assay can include repurposed FDA-approved drugs—medications originally developed for other diseases but shown to have anticancer potential in specific contexts.

This flexibility is especially valuable for patients with aggressive or treatment-resistant cancers, where time is critical and options are limited.

A Personal Journey Behind the Science

The driving force behind SageMedic is Dr Chris Apfel, co-founder and CEO of the company. A physician-scientist with over 100 peer-reviewed publications, Dr. Apfel is best known for developing the Apfel Score, a clinical prediction model published in The New England Journal of Medicine and used globally to assess postoperative nausea and vomiting risk. 

His commitment to transforming cancer care, however, is deeply personal.

Dr. Apfel’s mother was diagnosed with ovarian cancer and underwent recommended treatments—only to lose a painful battle with the disease. Years later, when his father developed lung cancer, he chose to forgo treatment altogether, having witnessed his wife’s suffering. These experiences exposed the harsh realities and limitations of existing cancer therapies.

Determined to make treatment more effective and humane, Dr. Apfel left clinical practice at University of California San Francisco, earned an MBA from Wharton School, and founded SageMedic to bridge science, medicine, and innovation.

About SageMedic

SageMedic is a California-based clinical laboratory fully accredited under the Clinical Laboratory Improvement Amendments (CLIA) by COLA and the Centers for Medicare & Medicaid Services. Founded by Drs. Chris and Brigitte Apfel, the company is dedicated to making cancer treatment more precise, humane, and effective through live tumour profiling  

Cancer treatment does not fail because doctors lack expertise or commitment. It fails because biology is complex—and averages are not enough. Technologies like the SAGE Oncotest™ suggest a future where therapy selection is guided not just by what should work statistically, but by what does work biologically for each individual.

In that future, fewer patients will endure ineffective treatments, and more will receive the right therapy, at the right time, for the right reason.