Voskoglou-Nomikos Theodora, Pater Joseph L, Seymour Lesley
National Cancer Institute of Canada Clinical Trials Group, Cancer Clinical Trials Division, Cancer Research Institute, Queen's University, 10 Stuart Street, Kingston, Ontario, K7L 3N6 Canada.
Clin Cancer Res. 2003 Sep 15;9(11):4227-39.
We looked at the value of three preclinical cancer models, the in vitro human cell line, the human xenograft, and the murine allograft, to examine whether they are reliable in predicting clinical utility.
Thirty-one cytotoxic cancer drugs were selected. Literature was searched for drug activity in Phase II trials, human xenograft, and mouse allografts in breast, non-small cell lung, ovary, and colon cancers. Data from the National Cancer Institute Human Tumor Cell Line Screen were used to calculate drug in vitro preclinical activity for each cancer type. Phase II activity versus preclinical activity scatter plot and correlation analysis was conducted for each model, by tumor type (disease-oriented approach), using one tumor type as a predictor of overall activity in the other three tumor types combined (compound-oriented approach) and for all four tumor types together.
The in vitro cell line model was predictive for non-small cell lung cancer under the disease-oriented approach, for breast and ovarian cancers under the compound-oriented approach, and for all four tumor types together. The mouse allograft model was not predictive. The human xenograft model was not predictive for breast or colon cancers, but was predictive for non-small cell lung and ovarian cancers when panels of xenografts were used.
These results suggest that under the right framework and when panels are used, the in vitro cell line and human xenograft models may be useful in predicting the Phase II clinical trial performance of cancer drugs. Murine allograft models, as used in this analysis, appear of limited utility.
我们研究了三种临床前癌症模型(体外人细胞系、人异种移植瘤和小鼠同种异体移植瘤)的价值,以检验它们在预测临床效用方面是否可靠。
选择了31种细胞毒性抗癌药物。检索了关于这些药物在乳腺癌、非小细胞肺癌、卵巢癌和结肠癌的II期试验、人异种移植瘤和小鼠同种异体移植瘤中的活性的文献。利用美国国立癌症研究所人类肿瘤细胞系筛选的数据计算每种癌症类型的药物体外临床前活性。针对每个模型,按肿瘤类型(以疾病为导向的方法)、使用一种肿瘤类型作为其他三种肿瘤类型总体活性的预测指标(以化合物为导向的方法)以及针对所有四种肿瘤类型一起进行II期活性与临床前活性的散点图和相关性分析。
在以疾病为导向的方法下,体外细胞系模型对非小细胞肺癌具有预测性;在以化合物为导向的方法下,对乳腺癌和卵巢癌具有预测性;对所有四种肿瘤类型都具有预测性。小鼠同种异体移植瘤模型没有预测性。人异种移植瘤模型对乳腺癌或结肠癌没有预测性,但当使用异种移植瘤面板时,对非小细胞肺癌和卵巢癌具有预测性。
这些结果表明,在合适的框架下且使用面板时,体外细胞系和人异种移植瘤模型可能有助于预测癌症药物的II期临床试验表现。本分析中使用的小鼠同种异体移植瘤模型似乎效用有限。