Moon Yong Wha, Choi Sung Ho, Kim Yong Tai, Sohn Joo Hyuk, Chang Joon, Kim Se Kyu, Park Moo Suk, Chung Kyung Young, Lee Hyoun Ju, Kim Joo-Hang
Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, and Department of Division of Hemato-Oncology, National Health Insurance Corp., Ilsan Hospital, Kyonggi-do, Korea.
Cancer. 2007 May 1;109(9):1829-35. doi: 10.1002/cncr.22601.
The study investigated correlations between adenosine triphosphate / chemotherapy response assay (ATP-CRA) and clinical outcomes after ATP-CRA-guided platinum-based chemotherapy for unresectable nonsmall-cell lung cancer (NSCLC).
The authors performed an in vitro chemosensitivity test, ATP-CRA, to evaluate the chemosensitivities of anticancer drugs such as cisplatin, carboplatin, paclitaxel, docetaxel, gemcitabine, and vinorelbine for chemonaive, unresectable NSCLC. The cell death rate was determined by measuring the intracellular ATP levels of drug-exposed cells compared with untreated controls. A sensitive drug was defined as a drug producing 30% or more reduction in ATP compared with untreated controls. Assay-guided platinum-based 2-drug chemotherapy was given to patients with pathologically confirmed NSCLC.
Thirty-four patients were enrolled. Thirty tumor specimens were obtained by bronchoscopic biopsies and 4 obtained surgically. The median age was 61 years and 27 patients had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. The response rate was 43.8%. At a median follow-up period of 16.9 months, the median progression-free and overall survivals were 3.6 and 11.2 months, respectively. Patients were dichotomized into the platinum-sensitive (S; 20 patients) and resistant (R; 14 patients) groups. The positive/negative predictive values were 61.1% and 78.6% with a predictive accuracy of 68.8%. Although without significant differences in pretreatment parameters, the S-group showed better clinical response (P=.036), longer progression-free survival (P=.060), and longer overall survival (P=.025).
Despite using bronchoscopic biopsied specimens, ATP-CRA and clinical outcomes correlated well after assay-guided platinum-based 2-drug chemotherapy for unresectable NSCLC. There was a favorable response and survival in the platinum-sensitive vs resistant groups.
本研究调查了三磷酸腺苷/化疗反应分析（ATP-CRA）与不可切除非小细胞肺癌（NSCLC）患者在ATP-CRA指导下接受铂类化疗后的临床结局之间的相关性。
作者进行了体外化疗敏感性试验，即ATP-CRA，以评估顺铂、卡铂、紫杉醇、多西他赛、吉西他滨和长春瑞滨等抗癌药物对初治、不可切除NSCLC的化疗敏感性。通过测量药物处理细胞与未处理对照细胞的细胞内ATP水平来确定细胞死亡率。敏感药物定义为与未处理对照相比使ATP降低30%或更多的药物。对病理确诊的NSCLC患者给予分析指导下的铂类两药联合化疗。
纳入34例患者。通过支气管镜活检获得30个肿瘤标本，并通过手术获得4个标本。中位年龄为61岁，27例患者东部肿瘤协作组（ECOG）体能状态为0-1。缓解率为4
