Correlation of the clinical response to chemotherapy in breast cancer with ex vivo chemosensitivity
Correlation of the clinical response to chemotherapy in breast cancer with ex vivo chemosensitivity
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DOI：
10.1097/00001813-199608000-00002
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发表时间：
1996-08-01
影响因子：
2.3
通讯作者：
Bruckner, HW
中科院分区：
文献类型：
--
作者：
Cree, IA;Kurbacher, CM;Bruckner, HW
乳腺癌的化疗是根据临床试验的经验信息进行的，这种方法没有考虑到患者之间化疗敏感性的已知异质性。以前的尝试，以确定体外化疗敏感性已令人失望，但在这项研究中，结果从一个新开发的肿瘤化疗敏感性测定（TCA）已与患者的反应，在这项研究中，我们已经使用异质性数据的标准方案从116个乳腺TCA设置敏感性/耐药阈值，然后用于解释那些已知的临床反应的结果。在手术活检中，测定可评价性为97%。III期/可评估疾病的临床随访从27个乳腺肿瘤中获得，这些肿瘤成功地进行了化学敏感性测试，包括13个针穿刺活检。ATP-TCA测定在29个具有临床可评估疾病的肿瘤中的22个（76%）中正确预测反应，表明其能够预测个体患者的结果。在化疗前后使用残留或复发的肿瘤组织对7名患者进行测定。4例初始敏感的患者在开始化疗后6个月内显示敏感性下降，而另外2例无临床耐药的患者仍然对TCA敏感。根据TCA敏感性给予的所有9个疗程均导致部分或完全缓解。在广泛采用TCA技术之前，应进行TCA导向治疗与标准经验治疗的对照试验，以评估其对应答率、生存率和治疗费用的影响。
Chemotherapy for breast cancer is given on the basis of empirical information from clinical trials, an approach which fails to take into account the known heterogeneity of chemosensitivity between patients. Previous attempts to determine chemosensitivity ex vivo have been disappointing, but In this study results from a newly developed tumor chemosensitivity assay (TCA) have been correlated prospectively with patient response, In this study, we have used heterogeneity data for standard regimens obtained from 116 breast TCAs to set sensitivity/resistance thresholds which were then used to Interpret the results from those with known clinical responses. Assay evaluability was 97% in surgical biopsies. clinical follow-up of stage III/assessable disease was obtained from 27 breast tumors which were successfully tested for chemosensitivity, including 13 needle biopsies. The ATP-TCA assay predicted response correctly in 22 out of 29 (76%) tumors with clinically evaluable disease, suggesting that it Is capable of predicting outcome in individual patients, Assays were performed in seven patients before and after chemotherapy using residual or recurrent tumor tissue. Four cases with initial sensitivity showed a decrease in sensitivity within 6 months of starting chemotherapy, while two others without clinical resistance were still sensitive by TCA. All nine courses of therapy given on the basis of TCA sensitivity resulted in partial or complete responses. Controlled trials of TCA-directed treatment against standardized empirical therapy should he conducted before this technology is widely adopted to assess its impact on rates of response, survival and the cost of treatment.