Tailor-made chemotherapy against malignant gliomas based on chemosensitivity test and analysis of drug resistance gene

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Each malignant glioma shows different effect of anti-cancer drug. This mechanism could be related to expression of drug resistance gene. Effect of anti-cancer drug in vitro is examined with chemosensitivity test. Tailor made chemotherapy for malignant glioma was based on chemosensitivity test with collagen gel matrix method. In addition, mRNA expression of drug resistance gene was analyzed with RT-PCR method. Fifty-three cases of malignant gliomas (anaplastic astrocytoma, glioblastoma) were examined Tumor tissues obtained at surgery were cultured for 8 days for chemosensitivity test with collagen gel matrix method for 6 to 9 anti-cancer drugs. According to chemosensitivity, tow anti-cencer drugs were selected and injected through intra-arterial route. In addition, total RNA was extracted and RT-PCR method was performed for drug resistance genes such as MDR and Topo II. The result of chemosensitivity test was compared with expressions of drug resistance genes. Mean inhibition rate of tumor growth in chemosensitivity test showed 42.7% in CBDCA, 37.9% in CDDP, 30.8% in ACNU, and 3.2% in VCR. This result revealed high sensitivity in platinum drugs. Drug resistance gene expression was not significantly correlated with chemosensitivity (p=0.1). In addition, mean survival period of patients undergone with tailor made chemotherapy based on chemosensitivity test was not significantly different from mean survival period of patients undergone with conventional chemotherapy (p=0.07). In spite of small number of examined cases, tailor made chemotherapy should be further investigated.