Anayama Takashi, Taguchi Mai, Tatenuma Takehiro, Okada Hironobu, Miyazaki Ryohei, Hirohashi Kentaro, Kume Motohiko, Matsusaki Keisuke, Orihashi Kazumasa
Department of Surgery II, Kochi Medical School, Kochi University, Kochi 783-8505, Japan.
Japanese CART Study Group, Kaname Second Clinic, Kanamecho Hospital, Tokyo 171-0043, Japan.
World J Clin Cases. 2019 Dec 6;7(23):4036-4043. doi: 10.12998/wjcc.v7.i23.4036.
We report the first case, to the best of our knowledge, of massive ascites due to recurrent malignant pleural mesothelioma that was controlled using KM-cell-free and concentrated ascites reinfusion therapy (KM-CART). The tumor cells derived KM-CART were utilized secondarily in an cell growth assay using the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) to investigate anticancer drug susceptibility.
A 56-year-old man presented with recurrent malignant mesothelioma with massive ascites; more than 4000 mL of ascitic fluid was removed, filtered, and concentrated using KM-CART, and the cell-free ascitic fluid was reinfused into the patient to improve quality of life. Cancer cells isolated secondarily in an proliferation assay using CD-DST exhibited low sensitivity to pemetrexed and high sensitivity to gemcitabine. Treatment with gemcitabine maintained stable disease for 4 mo.
The combination of KM-CART and CD-DST may be a promising treatment option for malignant ascites associated with malignant mesothelioma.
据我们所知，我们报告了首例因复发性恶性胸膜间皮瘤导致大量腹水，采用无KM细胞和浓缩腹水回输疗法（KM-CART）进行控制的病例。KM-CART衍生的肿瘤细胞随后用于胶原凝胶微滴包埋培养药物敏感性试验（CD-DST）的细胞生长试验，以研究抗癌药物敏感性。
一名56岁男性，患有复发性恶性间皮瘤并伴有大量腹水；使用KM-CART去除、过滤并浓缩了超过4000 mL的腹水，将无细胞腹水回输到患者体内以改善生活质量。在使用CD-DST的增殖试验中二次分离的癌细胞对培美曲塞表现出低敏感性，对吉西他滨表现出高敏感性。吉西他滨治疗使疾病稳定了4个月。
KM-CART与CD-DST联合应用可能是治疗恶性间皮瘤相关恶性腹水的一种有前景的治疗选择。
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