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使用患者来源的肿瘤类器官培养模型预测 IV 期结直肠癌对化疗方案反应的准确性:一项盲法研究。

Accuracy of Using a Patient-Derived Tumor Organoid Culture Model to Predict the Response to Chemotherapy Regimens In Stage IV Colorectal Cancer: A Blinded Study.

机构信息

Department of General Surgery, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.

Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Cancer, Guangzhou, Guangdong, China.

出版信息

Dis Colon Rectum. 2021 Jul 1;64(7):833-850. doi: 10.1097/DCR.0000000000001971.

DOI:10.1097/DCR.0000000000001971
PMID:33709991
Abstract

BACKGROUND

Patient-derived tumor organoid culture has emerged as a preclinical model that has the potential to predict individual drug response. However, the predictive accuracy of patient-derived tumor organoid culture models for responses to chemotherapy regimens in stage IV colorectal cancer remains unknown.

OBJECTIVE

The purpose of this study was to evaluate the predictive accuracy of the patient-derived tumor organoid culture model for responses to chemotherapy regimens in stage IV colorectal cancer.

DESIGN

A pilot study was performed to define the half-maximal inhibitory concentration of the response to chemotherapy regimens in the patient-derived tumor organoid culture model. Then, a blinded study was performed to evaluate the predictive accuracy of the patient-derived tumor organoid culture model for responses to chemotherapy regimens.

SETTINGS

Cancer samples were collected from patients with stage IV colorectal cancer at Nanfang Hospital of Southern Medical University in China.

PATIENTS

In the pilot study, 30 patients were enrolled, and 43 samples were collected. In the blinded study, 71 patients were enrolled, and 96 samples were collected.

INTERVENTION

Patient-derived tumor organoid culture and chemotherapy regimens were tested.

MAIN OUTCOME MEASURES

The predictive accuracy of the patient-derived tumor organoid model for responses to chemotherapy regimens was measured.

RESULTS

The median (range) time of organoid culture and drug testing was 9 days (range, 7-14 d). In the pilot study, 30 samples (69.77% [30/43]) were successfully cultured. The half-maximal inhibitory concentration of the chemotherapy response was 10 µmol/L according to clinical chemotherapy outcomes. In the blinded study, 77 samples (80.21% [77/96]) from 57 patients were successfully cultured. The sensitivity, specificity, and accuracy of the patient-derived tumor organoid model for predicting responses to chemotherapy regimens were 63.33%, 94.12%, and 79.69%.

LIMITATIONS

This was a blinded study rather than a prospective randomized controlled study.

CONCLUSIONS

The patient-derived tumor organoid culture model effectively predicts responses to existing chemotherapy regimens for individual patients. Video Abstract at http://links.lww.com/DCR/B511.

PRECISIN EN EL USO DE MODELOS DE CULTIVO DE ORGANOIDES TUMORALES DERIVADOS DE PACIENTES PARA PREDECIR LA RESPUESTA DEL RGIMEN DE QUIMIOTERAPIA EN CNCER COLORRECTAL ESTADIO IV ESTUDIO CIEGO

ANTECEDENTES:El cultivo de organoides tumorales derivado del paciente ha surgido como un modelo preclínico que tiene el potencial de predecir la respuesta a un fármaco individual. Sin embargo, la exactitud predictiva en los modelos de cultivo de organoides tumorales derivados de pacientes para las respuestas a los regímenes de quimioterapia en el cáncer colorrectal en estadio IV sigue siendo desconocida.OBJETIVO:Evaluar la exactitud predictiva del modelo de cultivo organoide tumoral derivado de pacientes para las respuestas a los regímenes de quimioterapia en el cáncer colorrectal en estadio IV.DISEÑO:Se realizó un estudio piloto para definir la concentración inhibitoria media máxima de la respuesta a los regímenes de quimioterapia en el modelo de cultivo organoide tumoral derivado de pacientes. Luego, se realizó un estudio ciego para evaluar la exactitud predictiva del modelo de cultivo organoide tumoral derivado de pacientes para las respuestas a los regímenes de quimioterapia.AJUSTE:Se recolectaron muestras de cáncer de pacientes con cáncer colorrectal en estadio IV en el Hospital Nanfang de la Universidad Médica del Sur en China.PACIENTES:En el estudio piloto, se inscribieron 30 pacientes y se recolectaron 43 muestras. En el estudio ciego, se inscribieron 71 pacientes y se recolectaron 96 muestras.INTERVENCIÓN:Se probaron cultivos de organoides de tumores derivados del paciente y regímenes de quimioterapia.PRINCIPALES MEDIDAS DE RESULTADO:La precisión predictiva del modelo organoide tumoral derivado del paciente para las respuestas a los regímenes de quimioterapia.RESULTADOS:La mediana (rango) de tiempo de cultivo organoide y prueba de drogas fue de 9 (7-14) días. En el estudio piloto, se cultivaron con éxito 30 (69,77% [30/43]) muestras. La concentración inhibidora media máxima de la respuesta a la quimioterapia fue de 10 µmol / L según los resultados de la quimioterapia clínica. En el estudio ciego, se cultivaron con éxito 77 muestras (80,21% [77/96]) de 57 pacientes. La sensibilidad, especificidad y precisión del modelo organoide tumoral derivado del paciente para predecir las respuestas a los regímenes de quimioterapia fueron 63,33%, 94,12% y 79,69%, respectivamente.LIMITACIONES:Este fue un estudio ciego en lugar de un estudio prospectivo, aleatorizado y controlado.CONCLUSIONES:El modelo de cultivo organoide tumoral derivado de pacientes predice eficazmente las respuestas a los regímenes de quimioterapia existentes para pacientes individuales. Consulte Video Resumen en http://links.lww.com/DCR/B511.

摘要

背景

患者来源的肿瘤类器官培养已成为一种具有预测个体药物反应潜力的临床前模型。然而,患者来源的肿瘤类器官培养模型预测晚期结直肠癌化疗方案反应的准确性尚不清楚。

目的

本研究旨在评估患者来源的肿瘤类器官培养模型预测晚期结直肠癌化疗方案反应的准确性。

设计

进行了一项初步研究,以确定患者来源的肿瘤类器官培养模型对化疗方案反应的半最大抑制浓度。然后,进行了一项盲法研究,以评估患者来源的肿瘤类器官培养模型预测化疗方案反应的准确性。

地点

中国南方医科大学南方医院收集了晚期结直肠癌患者的癌症样本。

患者

在初步研究中,纳入了 30 名患者,采集了 43 份样本。在盲法研究中,纳入了 71 名患者,采集了 96 份样本。

干预措施

进行了患者来源的肿瘤类器官培养和化疗方案测试。

主要观察指标

评估患者来源的肿瘤类器官模型预测化疗方案反应的准确性。

结果

类器官培养和药物测试的中位(范围)时间为 9 天(范围,7-14 天)。在初步研究中,成功培养了 30 个样本(69.77%[30/43])。根据临床化疗结果,化疗反应的半最大抑制浓度为 10µmol/L。在盲法研究中,成功培养了 57 名患者中的 77 个样本(77/96,80.21%)。患者来源的肿瘤类器官模型预测化疗方案反应的敏感性、特异性和准确性分别为 63.33%、94.12%和 79.69%。

局限性

这是一项盲法研究,而不是前瞻性随机对照研究。

结论

患者来源的肿瘤类器官培养模型可有效预测现有化疗方案对个体患者的反应。视频摘要可在 http://links.lww.com/DCR/B511 查看。

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