Use of an ex vivo ATP luminescence assay to direct chemotherapy for recurrent ovarian cancer
Use of an ex vivo ATP luminescence assay to direct chemotherapy for recurrent ovarian cancer
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DOI：
10.1097/00001813-199801000-00006
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发表时间：
1998-01-01
影响因子：
2.3
通讯作者：
Andreotti, PE
中科院分区：
文献类型：
--
作者：
Kurbacher, CM;Cree, IA;Andreotti, PE
化疗对复发性卵巢癌（ROC）产生的反应率为10-80%，这取决于铂耐药性的流行程度。大多数患者在1年内复发，中位无进展生存期（PFS）通常不超过6个月。以往的治疗前化疗敏感性试验大多未能改善患者的ROC预后。新开发的ATP分析显示有希望与临床结果回顾性相关。我们在此报告ATP测定指导化疗在ROC患者中的初步结果。在一项前瞻性开放标签先导试验中，通过ATP肿瘤化疗敏感性试验（ATP- tca）选择治疗方法。回顾性比较前25例可评估患者的客观缓解率（ORR）、PFS和总生存期（OAS）与其他30例具有相似特征的同期经验治疗患者的客观缓解率（ORR）、PFS和总生存期（OAS）。精算中位观察时间，ATP-TCA组为80周，对照组为83.5周。在对照组中，37%的ORR（2个完全缓解（CR）和9个部分缓解（PR））之后，中位PFS为20周，中位OAS为69周，主要与使用单药化疗有关。ATP-TCA组的ORR为64%(8例CR和8例PR) (p=0.04)，大多数应答（16例中的11例）是通过新颖的组合实现的。该组中位PFS为50周（p=0.003），中位OAS为97周（p=0.145）。两组患者的生存率相似。在ATP-TCA指导下的化疗在铂难治患者的ORR和PFS方面都产生了更大的益处。atp - tca定向化疗的ROC优于临床医生选择的化疗，并且经常导致选择新的药物组合。这些有希望的结果现在需要前瞻性随机试验的证实。[C] 1998 Rapid Science Ltd.]
Chemotherapy for recurrent ovarian carcinoma (ROC) produces response rates of 10-80% depending on the prevalence of platinum resistance. Most patients relapse within 1 year and median progression-free survival (PFS) is generally no more than 6 months. Previous pretherapeutic chemosensitivity assays mostly failed to improve the outcome of patients with ROC. Newly developed ATP assays show promising retrospective correlation with clinical outcome. We report here the first results of ATP assay-directed chemotherapy in patients with ROC. Therapy was selected by the ATP tumor chemosensitivity assay (ATP-TCA) in a prospective open-label pilot trial for ROC. Objective response rate (ORR), PFS and overall survival (OAS) of the first 25 evaluable patients were retrospectively compared with those of 30 others having similar characteristics who were treated empirically within the same period. The actuarial median observation times were 80 weeks for the ATP-TCA group and 83.5 weeks for the control group, respectively. In the control group, a 37% ORR [two complete responses (CR) and nine partial responses (PR)] was followed by a median PFS of 20 weeks and a median OAS of 69 weeks, mainly related to the use of single-agent chemotherapy. The ORR in the ATP-TCA group was 64% (eight CR and eight PR) (p=0.04) with the majority of responses (11 of 16) achieved with novel combinations. The median PFS in this group was 50 weeks (p=0.003) and the median OAS was 97 weeks (p=0.145). Survival of responding patients was similar in both groups. Chemotherapy guided by the ATP-TCA produced a greater benefit with regard to both ORR and PFS in platinum-refractory patients. ATP-TCA-directed chemotherapy for ROC compares favorably with chemotherapy chosen by a clinician and often leads to the choice of novel drug combinations. These promising results now warrant confirmation by prospective randomized trials. [(C) 1998 Rapid Science Ltd.].