Individualized Tumor Response Testing for Prediction of Response to Paclitaxel and Cisplatin Chemotherapy in Patients with Advanced Gastric Cancer

Title
Individualized Tumor Response Testing for Prediction of Response to Paclitaxel and Cisplatin Chemotherapy in Patients with Advanced Gastric Cancer
Author(s)
이경희김지현[김지현]이근욱[이근욱]김열홍[김열홍]오도윤[오도윤]김준희[김준희]양성현[양성현]임석아[임석아]최성호[최성호]방영재[방영재]
Keywords
CELL LUNG-CANCER; PROSPECTIVE CLINICAL-TRIAL; IN-VITRO CHEMOSENSITIVITY; ATP-BIOLUMINESCENCE ASSAY; OVARIAN-CANCER; BREAST-CANCER; LUMINESCENCE ASSAY; RESISTANCE ASSAYS; SENSITIVITY; HETEROGENEITY
Issue Date
201005
Publisher
KOREAN ACAD MEDICAL SCIENCES
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.25, no.5, pp.684 - 690
Abstract
The purpose of our study was to determine the most accurate analytic method to define in vitro chemosensitivity, using clinical response as reference standard in prospective clinical trial, and to assess accuracy of adenosine triphosphate-based chemotherapy response assay (ATP-CRA). Forty-eight patients with chemo-naive, histologically confirmed, locally advanced or metastatic gastric cancer were enrolled for the study and were treated with combination chemotherapy of paclitaxel 175 mg/m(2) and cisplatin 75 mg/m2 for maximum of six cycles after obtaining specimen for ATP-CRA. We performed the receiver operator characteristic curve analysis using patient responses by WHO criteria and ATP-CRA results to define the method with the highest accuracy. Median progression free survival was 4.2 months (95% confidence interval [CI]: 3.4-5.0) and median overall survival was 11.8 months (95% CI: 9.7-13.8) for all enrolled patients. Chemosensitivity index method yielded highest accuracy of 77.8% by ROC curve analysis, and the specificity, sensitivity, positive and negative predictive values were 95.7%, 46.2%, 85.7%, and 75.9%. In vitro chemosensitive group showed higher response rate (85.7% vs. 24.1%) (P=0.005) compared to chemoresistant group. ATP-CRA could predict clinical response to paclitaxel and cisplatin chemotherapy with high accuracy in advanced gastric cancer patients. Our study supports the use of ATP-CRA in further validation studies.
URI
http://hdl.handle.net/YU.REPOSITORY/22473http://dx.doi.org/10.3346/jkms.2010.25.5.684
ISSN
1011-8934
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의과대학 > 내과학교실 > Articles
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