Individualized tumor response testing for prediction of response to paclitaxel and cisplatin chemotherapy in patients with advanced gastric cancer

Jee Hyun Kim, Keun Wook Lee, Yeul Hong Kim, Kyung Hee Lee, Do Youn Oh, Joonhee Kim, Sung Hyun Yang, Seock Ah Im, Sung Ho Choi, Yung Jue Bang

    Research output: Contribution to journalArticlepeer-review

    12 Citations (Scopus)

    Abstract

    The purpose of our study was to determine the most accurate analytic method to define in vitro chemosensitivity, using clinical response as reference standard in prospective clinical trial, and to assess accuracy of adenosine triphosphate-based chemotherapy response assay (ATP-CRA). Forty-eight patients with chemo-naïve, histologically confirmed, locally advanced or metastatic gastric cancer were enrolled for the study and were treated with combination chemotherapy of paclitaxel 175 mg/m2 and cisplatin 75 mg/m2 for maximum of six cycles after obtaining specimen for ATP-CRA. We performed the receiver operator characteristic curve analysis using patient responses by WHO criteria and ATP-CRA results to define the method with the highest accuracy. Median progression free survival was 4.2 months (95% confidence interval [CI]: 3.4-5.0) and median overall survival was 11.8 months (95% CI: 9.7-13.8) for all enrolled patients. Chemosensitivity index method yielded highest accuracy of 77.8% by ROC curve analysis, and the specificity, sensitivity, positive and negative predictive values were 95.7%, 46.2%, 85.7%, and 75.9%. In vitro chemosensitive group showed higher response rate (85.7% vs. 24.1%) (P=0.005) compared to chemoresistant group. ATP-CRA could predict clinical response to paclitaxel and cisplatin chemotherapy with high accuracy in advanced gastric cancer patients. Our study supports the use of ATP-CRA in further validation studies.

    Original languageEnglish
    Pages (from-to)684-690
    Number of pages7
    JournalJournal of Korean medical science
    Volume25
    Issue number5
    DOIs
    Publication statusPublished - 2010 May

    Keywords

    • Antineoplastic agents
    • Antitumor
    • Cisplatin
    • Drug screening assays
    • Paclitaxel
    • Sensitivity and specificity
    • Stomach neoplasms
    • Therapeutic use

    ASJC Scopus subject areas

    • General Medicine

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