Gao Yu-tao, Wu Ling-ying, Zhang Wei, Zhao Dan, Li Ning, Tian Hai-mei, Wang Xiao-bing, Li Mo, Sun Yang-chun, Li Nan, Li Xiao-guang
Department of Gynecologic Oncology, Chinese Academy of Medical Sciences, Beijing, China.
Zhonghua Fu Chan Ke Za Zhi. 2013 May;48(5):358-63.
To investigate the efficacy of adenosine triphosphate (ATP)-tumor chemosensitivity assay (TCA) directed chemotherapy in patients with recurrent epithelial ovarian cancer.
From August 2010 to June 2012, recurrent epithelial ovarian cancer patients were prospectively enrollmented in Cancer Hospital, Peking Union Medical College,Chinese Academy of Medical Sciences.The entry criteria are as follows: (1) Histologically proven to be epithelial ovarian cancer. (2) Patients of recurrent ovarian cancer with bidimensionally measurable tumor, or ascitic or pleural fluid for testing. (3) Karnofsky performance status > 60. (4) A life expectancy of at least more than 6 months.According to patients desires, they were assigned into two groups: assay-directed therapy group and physician's-choice therapy group, patients' clinical and pathological characteristics, response rate to chemotherapy and progression-free survival (PFS) were compared between two groups.
A total of 113 patients with recurrent epithelial ovarian cancer were prospectively enrollmented to assay-directed chemotherapy (n = 56) or physician's-choice chemotherapy (n = 57).There was no difference in median age,types of recurrence, surgical-pathological stage, pathological type, tumor grade, times of recurrence, residual disease at secondary cytoreductive surgery between assay-directed group and physician's-choice group. The overall response rate (ORR) and median PFS in the ATP-TCA group was 66% (37/56) and 7 months, while the ORR in the control group was 46% (26/57, P = 0.037), the median PFS was 4 months (P = 0.040). For platinum-resistant patients, the ORR between ATP-TCA directed chemotherapy 59% (16/27) and control group 25% (7/28) were significantly different (P = 0.010), and the median PFS between two groups were also significantly different (5 months and 2 months, respectively, P = 0.003).
ATP-TCA directed chemotherapy could improve ORR and PFS in patients with recurrent epithelial ovarian cancer, especially in platinum-resistant patients.
探讨三磷酸腺苷（ATP）肿瘤药敏试验（TCA）指导下的化疗对复发性上皮性卵巢癌患者的疗效。
2010年8月至2012年6月，前瞻性纳入中国医学科学院北京协和医学院肿瘤医院的复发性上皮性卵巢癌患者。入选标准如下：（1）组织学确诊为上皮性卵巢癌。（2）复发性卵巢癌患者有二维可测量肿瘤，或有腹水或胸水用于检测。（3）卡氏评分>60。（4）预期寿命至少超过6个月。根据患者意愿，将其分为两组：试验指导治疗组和医生选择治疗组，比较两组患者的临床和病理特征、化疗反应率及无进展生存期（PFS）。
共113例复发性上皮性卵巢癌患者前瞻性纳入试验指导化疗组（n = 56）或医生选择化疗组（n = 57）。试验指导组和医生选择组在中位年龄、复发类型、手术病理分期、病理类型、肿瘤分级、复发次数、二次减瘤手术时的残留病灶方面无差异。ATP-TCA组的总缓解率（ORR）为66%（37/56），中位PFS为7个月，而对照组的ORR为46%（26/57，P = 0.037），中位PFS为4个月（P = 0.040）。对于铂耐药患者，ATP-TCA指导化疗组的ORR为59%（16/27），与对照组的25%（7/28）有显著差异（P = 0.010），两组的中位PFS也有显著差异（分别为5个月和2个月，P = 0.003）。
ATP-TCA指导下的化疗可提高复发性上皮性卵巢癌患者的ORR和PFS，尤其是铂耐药患者。
