A newly developed in vitro chemosensitivity test (nuclear damage assay): application to ovarian cancer.

With a newly developed in vitro chemosensitivity test based on the morphological changes of nuclear damage (nuclear damage assay) described here, we were able to screen currently available anticancer drugs within 24 hr with a 100% success rate. In preclinical chemotherapy using four human ovarian epithelial tumor cell lines and their xenografts in nude mice, the in vitro/in vivo response (sensitive/sensitive and resistant/resistant) rate was 94%. The nuclear damage assay was used to determine the chemosensitivity in 49 patients (60 assays) with ovarian cancer. The response rate of the 13 patients with measurable tumors, 9 of whom showed resistance to CAP (cyclophosphamide, adriamycin, and cisplatin) therapy, was 46% when the patients were given various combination chemotherapy protocols consisting of more than one active agent selected from group A and B agents by the nuclear damage assay. The newly developed in vitro chemosensitivity test proved to be useful when selecting a second-line combination chemotherapy for patients with CAP-resistant ovarian cancer.