Title:Evaluation of the in vitro Chemosensitivity and Correlation with Clinical Outcomes in Lung Cancer using the ATP-TCA
VOLUME: 18 ISSUE: 1
Author(s):Zhiyao Chen, Shichao Zhang, Sheng Ma, Chang Li, Chun Xu, Yinfang Shen, Jun Zhao* and Liyan Miao*
Affiliation:Department of Clinical Pharmacology Research Lab., The First Affiliated Hospital of Soochow University, Suzhou, 215006, Department of Clinical Pharmacology Research Lab., The First Affiliated Hospital of Soochow University, Suzhou, 215006, Department of Clinical Pharmacology Research Lab., The First Affiliated Hospital of Soochow University, Suzhou, 215006, Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Department of Pathology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Department of Clinical Pharmacology Research Lab., The First Affiliated Hospital of Soochow University, Suzhou, 215006
Keywords:Lung cancer, chemotherapy, ATP-based tumor chemosensitivity assay, in vitro chemosensitivity, clinical outcomes, MDR, lung
squamous cell carcinoma.
Abstract:Background and Objective: Multiple drug resistance (MDR) to chemotherapeutic agents often leads
to a failure to respond to chemotherapy. We utilized an in vitro chemosensitivity test to identify sensitive and
effective chemotherapeutic drugs and further elucidated the correlation between the in vivo chemosensitivity and
clinical outcomes.
Methods: Here, we evaluated the in vitro chemosensitivity and MDR of 120 lung cancer patients to eight singledrug
chemotherapies and of 291 lung cancer patients to seven chemotherapy regimens using an ATP-based
tumor chemosensitivity assay (ATP-TCA). Additionally, the chemosensitivity profiles of lung adenocarcinoma
patients (284 cases) and lung squamous cell carcinoma patients (90 cases) to these single-drug and chemotherapy
regimens were compared. Furthermore, the correlations between the chemosensitivity and clinical outcomes
were investigated in 16 stage III squamous cell carcinoma patients.
Results and Conclusion: PTX (51.7%), TXT (43.3%), GEM (12.5%), PTX+DDP (62.5%), TXT+L-OHP
(54.3%) and VP-16+DDP (16.2%) had the highest in vitro chemosensitivity rates. Approximately 31.7% of
patients developed resistance to all eight single-drug chemotherapies, and 25.8% of patients displayed resistance
to all seven chemotherapy regimens. In addition, lung squamous cell carcinoma was significantly more sensitive
to GEM and MTA+DDP than lung adenocarcinoma (P<0.05). Further analysis showed that patients with higher
drug sensitivity tended to have longer disease-free survival (18 months vs. 8.5 months) than patients displaying
drug resistance (P<0.05). These results suggest that the implementation of in vitro drug susceptibility testing
before chemotherapy can effectively prevent the occurrence of primary drug resistance and inappropriate drug
treatment.
