Clinical applications of the histoculture drug response assay

Toshiharu Furukawa, T. Kubota, R. M. Hoffman

Research output: Contribution to journalArticle

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Abstract

There is a need for a clinically useful drug-response assay for cancer patients to individualize their chemotherapy. Collagen sponge-gel-supported histoculture has been shown to maintain tissue architecture and function in vitro and has been utilized to develop the histoculture drug response assay (HDRA) for individualizing chemotherapy. In order to evaluate the HDRA with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide end point for clinical use, chemosensitivity to mitomycin C, doxorubicin, 5-fluorouracil, and cisplatin of 107 advanced gastric and 109 advanced colorectal cancers was determined in vitro in a correlative clinical trial. Two hundred eight (96.3%) of 216 of the patient specimens were evaluable in the HDRA. Thirty-eight patients with remaining measurable lesions after surgery were evaluable for comparison of the effects of chemotherapy in the HDRA with clinical outcome. Their overall response in the HDRA to all four drugs correlated to published historical data. Twenty-nine patients were treated with drugs shown to be ineffective in the HDRA, and all 29 cases showed clinical chemoresistance. In nine patients treated with drugs shown to be effective in the HDRA, six showed clinical chemoresponse and three showed arrest of disease progression. The correlation rate of the assay to clinical drug-sensitivity response was thus calculated to be 92.1% (35/38), with 100% (29/29) true-negative and 66.7% (6/9) true-positive rates, 100% (6/6) sensitivity, and 90.6% (29/32) specificity. Thirty-two patients with stage III and IV gastric cancer without remaining measurable tumor lesions after surgery were treated with mitomycin C and a fluoropyrimidine adjuvantly. The survival rate of 10 patients whose tumors were sensitive to either mitomycin C and/or 5-fluorouracil in the assay was significantly (P < 0.005) better than that of 22 patients whose tumors were shown to be insensitive to both drugs. Twenty-nine patients with stage III and IV colorectal cancer without remaining measurable tumor lesions after surgery were treated with fluoropyrimidines adjuvantly. The recurrence-free survival rate of 7 patients whose tumors were sensitive to 5-fluorouracil in the assay was significantly (P < 0.05) better than that of 22 patients whose tumors were insensitive. Thus the HDRA with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide end point should be of clinical value to choose optimal chemotherapy for response as well as for survival.

Original languageEnglish
Pages (from-to)305-311
Number of pages7
JournalClinical Cancer Research
Volume1
Issue number3
Publication statusPublished - 1995

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Pharmaceutical Preparations
Mitomycin
Neoplasms
Fluorouracil
Drug Therapy
Colorectal Neoplasms
Survival Rate
Porifera
Doxorubicin
Cisplatin
Stomach Neoplasms
Disease Progression
Stomach
Collagen
Gels
Clinical Trials
Recurrence
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Clinical applications of the histoculture drug response assay. / Furukawa, Toshiharu; Kubota, T.; Hoffman, R. M.

In: Clinical Cancer Research, Vol. 1, No. 3, 1995, p. 305-311.

Research output: Contribution to journalArticle

Furukawa, T, Kubota, T & Hoffman, RM 1995, 'Clinical applications of the histoculture drug response assay', Clinical Cancer Research, vol. 1, no. 3, pp. 305-311.
Furukawa, Toshiharu ; Kubota, T. ; Hoffman, R. M. / Clinical applications of the histoculture drug response assay. In: Clinical Cancer Research. 1995 ; Vol. 1, No. 3. pp. 305-311.
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