Greenberg B R, Salmon S E
J Clin Oncol. 1984 Jan;2(1):46-50. doi: 10.1200/JCO.1984.2.1.46.
The Human Tumor Clonogenic Assay (HTCA) was used in patients with unknown primary carcinomas (UPC) to evaluate chemosensitivity in vitro for this patient group and to possibly aid in the selection of chemotherapy for clinical trial. A total of 178 drug assays including 15 standard and 13 experimental anti-cancer drugs were performed on tumor cells from 19 patients. A median of six drugs were studied in vitro per patient. Sensitivity was noted in only 3.4% of the studies (six drug assays). The marked in vitro pattern of resistance observed with UPC correlates well with the known clinical experience with this entity. Ten patients were evaluable for clinical correlation of response between in vitro and in vivo sensitivity; however, many received drug combinations and not all the drugs had been tested in vitro. One of six evaluable patients exhibiting in vitro sensitivity and one of four with in vitro resistance achieved remission. Additional single-agent in vitro/in vivo correlations will be needed to establish whether HTCA will have any future impact in the treatment of patients with UPC. A more promising application of HTCA for UPC would appear to be as an aid in screening and discovery of new drugs of potentially greater efficacy for this resistant tumor category.
人类肿瘤克隆形成试验（HTCA）用于原发性不明癌症（UPC）患者，以评估该患者群体的体外化疗敏感性，并可能有助于为临床试验选择化疗方案。对19例患者的肿瘤细胞进行了总共178次药物检测，包括15种标准抗癌药物和13种实验性抗癌药物。每位患者体外研究的药物中位数为6种。仅在3.4%的检测（6次药物检测）中观察到敏感性。UPC患者体外明显的耐药模式与该疾病已知的临床经验密切相关。10例患者可评估体外和体内敏感性之间反应的临床相关性；然而，许多患者接受了联合用药，并非所有药物都进行了体外检测。6例可评估的体外敏感患者中有1例，4例体外耐药患者中有1例实现缓解。需要更多的单药体外/体内相关性研究，以确定HTCA是否会对UPC患者的治疗产生未来影响。HTCA在UPC中的一个更有前景的应用似乎是有助于筛选和发现对这种耐药肿瘤类型可能更有效的新药。
