Evaluation of the in vitro Chemosensitivity and Correlation with Clinical Outcomes in Lung Cancer using the ATP-TCA
Evaluation of the in vitro Chemosensitivity and Correlation with Clinical Outcomes in Lung Cancer using the ATP-TCA
复制标题
使用 ATP-TCA 评估肺癌体外化疗敏感性及其与临床结果的相关性
DOI：
10.2174/1871520617666170419123713
复制
发表时间：
2018-01-01
影响因子：
2.8
通讯作者：
Miao, Liyan
中科院分区：
文献类型：
--
作者：
Chen, Zhiyao;Zhang, Shichao;Miao, Liyan
背景与目的：化疗药物的多药耐药(MDR)常导致化疗失败。我们利用体外药敏试验来筛选敏感有效的化疗药物，并进一步阐明体内药敏与临床结果的相关性。方法：采用基于三磷酸腺苷的肿瘤药敏试验(ATP-TCA)，对120例肺癌患者和291例肺癌患者对8种单药化疗方案和291例肺癌患者对7种化疗方案的体外药敏和MDR进行了评估。此外，还比较了肺腺癌患者(284例)和肺鳞癌患者(90例)对这些单一药物和化疗方案的敏感性。结果与结论：PTX(51.7%)、TXT(43.3%)、GEM(12.5%)、PTX+DDP(62.5%)、TXT+L-OHP(54.3%)和VP-16+DDP(16.2%)药物敏感率最高。大约31.7%的患者对所有8种单一药物化疗产生耐药性，25.8%的患者对所有7种化疗方案表现出耐药性。另外，肺鳞癌对GEM和MTA+DDP的敏感性明显高于肺腺癌(P<；0.05)。进一步分析表明，药物敏感性较高的患者无病生存期(18个月比8.5个月)往往比耐药患者更长(P<；0.05)。提示化疗前实施体外药敏试验可有效预防原发耐药和药物治疗不当的发生。
Background and Objective: Multiple drug resistance (MDR) to chemotherapeutic agents often leads to a failure to respond to chemotherapy. We utilized an in vitro chemosensitivity test to identify sensitive and effective chemotherapeutic drugs and further elucidated the correlation between the in vivo chemosensitivity and clinical outcomes.Methods: Here, we evaluated the in vitro chemosensitivity and MDR of 120 lung cancer patients to eight single-drug chemotherapies and of 291 lung cancer patients to seven chemotherapy regimens using an ATP-based tumor chemosensitivity assay (ATP-TCA). Additionally, the chemosensitivity profiles of lung adenocarcinoma patients (284 cases) and lung squamous cell carcinoma patients (90 cases) to these single-drug and chemotherapy regimens were compared. Furthermore, the correlations between the chemosensitivity and clinical outcomes were investigated in 16 stage III squamous cell carcinoma patients.Results and Conclusion: PTX (51.7%), TXT (43.3%), GEM (12.5%), PTX+DDP (62.5%), TXT+L-OHP (54.3%) and VP-16+DDP (16.2%) had the highest in vitro chemosensitivity rates. Approximately 31.7% of patients developed resistance to all eight single-drug chemotherapies, and 25.8% of patients displayed resistance to all seven chemotherapy regimens. In addition, lung squamous cell carcinoma was significantly more sensitive to GEM and MTA+DDP than lung adenocarcinoma (P< 0.05). Further analysis showed that patients with higher drug sensitivity tended to have longer disease-free survival (18 months vs. 8.5 months) than patients displaying drug resistance (P< 0.05). These results suggest that the implementation of in vitro drug susceptibility testing before chemotherapy can effectively prevent the occurrence of primary drug resistance and inappropriate drug treatment.