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使用胶原凝胶滴包埋培养药敏试验(CD-DST)对不可切除的非小细胞肺癌(NSCLC)患者进行化疗敏感性测试的临床评估。

Clinical evaluation of chemosensitivity testing for patients with unresectable non-small cell lung cancer (NSCLC) using collagen gel droplet embedded culture drug sensitivity test (CD-DST).

作者信息

Kawamura Masafumi, Gika Masatoshi, Abiko Tomohiro, Inoue Yoshimasa, Oyama Takahiko, Izumi Yotaro, Kobayashi Hisayuki, Kobayashi Koichi

机构信息

Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.

出版信息

Cancer Chemother Pharmacol. 2007 Mar;59(4):507-13. doi: 10.1007/s00280-006-0292-8. Epub 2006 Aug 8.

Abstract

PURPOSE

In the present study, we prospectively evaluated the clinical feasibility and efficacy of collagen gel droplet embedded culture drug sensitivity test (CD-DST) in unresectable non-small cell lung cancer (NSCLC) without previous treatment.

EXPERIMENTAL DESIGN

Eighty patients with unresectable NSCLC, aged less than 81 years old, PS 0-1, and with evaluable tumor lesions, entered the study. If the patient had CD-DST active drugs, more than three cycles of chemotherapy containing these drugs were administered. If the patient did not have CD-DST active drugs, the patient could choose any treatment including best supportive care.

RESULTS

Of the 80 patients in this study, CD-DST yielded results successfully in 49 patients (61.3%). CD-DST active drugs were present in 22 patients, and significantly more female patients had in vitro active anticancer agents than male (P=0.0008). All of the patients with CD-DST active agents received chemotherapy including these agents. In these patients, the response rate was 72.7%, and median survival was 15.0 months. In the patients without CD-DST active agents, 11 patients received standard, empirical chemotherapy. In these patients, response rate was 0%, and median survival was 6.0 months.

CONCLUSIONS

The results show that CD-DST is capable of selecting the responders and the respective optimal regimens, and also delineating the patients less likely benefit from treatment.

摘要

目的

在本研究中,我们前瞻性地评估了胶原凝胶滴包埋培养药物敏感性试验(CD-DST)在未经治疗的不可切除非小细胞肺癌(NSCLC)中的临床可行性和疗效。

实验设计

80例年龄小于81岁、PS 0-1且有可评估肿瘤病灶的不可切除NSCLC患者进入本研究。如果患者有CD-DST活性药物,则给予包含这些药物的三个以上周期的化疗。如果患者没有CD-DST活性药物,患者可选择任何治疗,包括最佳支持治疗。

结果

本研究的80例患者中,49例(61.3%)成功获得CD-DST结果。22例患者有CD-DST活性药物,女性患者体外有活性抗癌药物的比例显著高于男性(P=0.0008)。所有有CD-DST活性药物的患者均接受了包含这些药物的化疗。在这些患者中,缓解率为72.7%,中位生存期为15.0个月。在没有CD-DST活性药物的患者中,11例接受了标准的经验性化疗。在这些患者中,缓解率为0%,中位生存期为6.0个月。

结论

结果表明,CD-DST能够筛选出有反应者和各自的最佳治疗方案,也能鉴别出不太可能从治疗中获益的患者。

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