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KMID : 1188520150110020051
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Korean Journal of Clinical Oncology
2015 Volume.11 No. 2 p.51 ~ p.58
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Clinical correlation between in vitro chemoresponse assay and first line chemotherapy for metastatic colorectal cancer patients
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Jung Sang-Hun
Kim So-Hyun
Kim Jae-Hwang
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Abstract
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Purpose: The study investigated correlations between adenosine triphosphate-based chemotherapy response assay (ATP-CRA) and clinical response after first line chemotherapy for metastatic colorectal cancer patients.
Methods: From June 2009 to June 2012, 24 patients were enrolled in this study. ATP-CRA was performed to evaluate the chemosensitivities of three combination anticancer drugs such as 5-fluorouracil (FU)+oxaliplatin and irinotecan, and capecitabine+oxaliplatin for metastatic colorectal cancer. A sensitive group (SG) and resistant group (RG) for chemotherapy regimen (oxaliplatin+5-FU+leucovorin [FOLFOX], n = 14; oxaliplatin+capecitabine [CapeOx], n = 2; irinotecan+5-FU+leucovorin [FOLFIRI], n = 8) was defined as cut-off value 30%. The outcomes were a correlation between the ATP-CRA results and the clinical response and progression-free survival.
Results: Patients were dichotomized into the SG (19 patients) and RG (5 patients) groups. There was no difference between groups, in terms of regimen, frequency and interval of chemotherapy. The disease control rate after first response evaluation was not shown statistically difference (89.5% in SG and 60.0% in RG, respectively, P = 0.15). And there was also no significance in second and third response evaluation. The median progression-free month were 7.0 (range, 2?27 month) and 5.0 (range, 3?12 month), respectively and shown marginal significance. However, there was no statistical difference in progression-free survival curve (P = 0.16). Sensitivity, specificity, positive prediction rate and negative prediction rage for disease control after first response was 85.0%, 50.0%, 89.5%, and 40.0%.
Conclusion: Although ATP-CRA may be helpful in predicting chemotherapy response in metastatic colorectal cancer, there was not conclusive. Therefore, we recommend further clinical studies to confirm the efficacy of chemoresponse assay for metastatic colorectal cancer.
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KEYWORD
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Colorectal cancer, Metastasis, Chemotherapy, Response
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