Taguchi T
Gan To Kagaku Ryoho. 1982 Apr;9(4):570-4.
Many anticancer drugs are now available for clinical use. Unfortunately, most are extremely toxic to normal tissue. Use of one or more toxic drugs inactive against the given patient's own cancer may not only deny the patients the benefit of active therapy but may actually make the patient's cancer grow faster. The need for adjuvant chemotherapy can scarcely be doubted. However, distant metastases may be present at the time of primary surgery in many cases. Some form of generalized therapy like drug therapy or immunotherapy must therefore be used to supplement our local form of treatment such as surgery and radiation therapy for cancer. Already the dangers of cancer chemotherapy are reported as adverse effect, not only in the case of advanced cancer patients, but, that of post operative adjuvant chemotherapy. Therefore, predictive assays analogous to antibiotic sensitivity tests are needed to rule out inactive drugs and select active drugs with least toxicity. The treatment of patients with cancer according to the result of tests of sensitivity of cancer cells to anticancer drugs has been introduced many years ago. The examination of the sensitivity is carried out on explanted tumor cells by two different methodical approaches-observation of the cytotoxic effect of the preparation tested to the growth of the tissue culture of the tumor examined, and a short-term examination with the indication of the effect of anticancer drugs according to the decreased utilization or incorporation of the precussors of the synthesis of proteins, RNA and DNA labeled with radioisotopes, or according to the release of enzymes from tumor cells damaged by an efficient anticancer drug. However, clinicians know that there are many disagreements between the sensitivity test and clinical results. Each sensitivity test has its limitation and problems for resolution. Research toward the goal of the sensitivity test is to divise more appropriate method which is simple prompt and precise for drug selection.
现在有许多抗癌药物可供临床使用。不幸的是，大多数药物对正常组织具有极高的毒性。使用一种或多种对特定患者自身癌症无活性的毒性药物，不仅可能使患者无法从积极治疗中获益，实际上还可能使患者的癌症生长得更快。辅助化疗的必要性几乎不容置疑。然而，在许多情况下，原发性手术时可能已经存在远处转移。因此，必须使用某种形式的全身治疗，如药物治疗或免疫治疗，来补充我们针对癌症的局部治疗方式，如手术和放射治疗。已经有报道称，癌症化疗的风险不仅在晚期癌症患者中，而且在术后辅助化疗中都表现为不良反应。因此，需要类似于抗生素敏感性测试的预测性检测，以排除无效药物并选择毒性最小的有效药物。根据癌细胞对抗癌药物的敏感性测试结果来治疗癌症患者的方法早在多年前就已引入。通过两种不同的方法对移植的肿瘤细胞进行敏感性检测：观察受试制剂对所检测肿瘤组织培养生长的细胞毒性作用，以及根据放射性同位素标记的蛋白质、RNA和DNA合成前体的利用率或掺入量的降低，或者根据有效抗癌药物损伤的肿瘤细胞释放的酶，来指示抗癌药物的作用进行短期检测。然而，临床医生知道敏感性测试与临床结果之间存在许多不一致之处。每种敏感性测试都有其局限性和有待解决的问题。朝着敏感性测试目标的研究是要设计出更合适的方法，这种方法对于药物选择来说简单、迅速且精确。
