CORRELATION OF INVITRO DRUG-SENSITIVITY TESTING RESULTS WITH RESPONSE TO CHEMOTHERAPY AND SURVIVAL IN EXTENSIVE-STAGE SMALL CELL LUNG-CANCER - A PROSPECTIVE CLINICAL-TRIAL

被引:94
作者
GAZDAR, AF
STEINBERG, SM
RUSSELL, EK
LINNOILA, RI
OIE, HK
GHOSH, BC
COTELINGAM, JD
JOHNSON, BE
MINNA, JD
IHDE, DC
机构
[1] NCI, BIOSTAT & DATA MANAGEMENT SECT, BETHESDA, MD 20205 USA
[2] USN HOSP, SURG SERV, BETHESDA, MD 20814 USA
[3] USN HOSP, PATHOL LAB, BETHESDA, MD 20814 USA
[4] UNIFORMED SERV UNIV HLTH SCI, BETHESDA, MD 20814 USA
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 1990年 / 82卷 / 02期
关键词
D O I
10.1093/jnci/82.2.117
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We devised a novel clinical protocol for extensive-stage small cell lung cancer (SCLC), selecting chemotherapy whenever possible on the basis of in vitro drug-sensitivity testing (DST) of individual patients' tumor specimens. Most of the specimens were obtained from metastatic sites during routine staging procedures. Increase of tumor cell number by culture in selective media usually was required before DST could be performed. We used the Weisenthal dye exclusion assay to place the seven drugs in rank order and to select the in vitro best regimen (IVBR), a three-drug combination of proved efficacy in SCLC. After initial staging and specimen acquisition, patients received etoposide and cisplatin (primary therapy) and were restaged after 12 weeks. Patients with partial or no responses and those relapsing after a complete response to primary therapy were switched to the IVBR if DST data were available. If DST data were unavailable, an empiric combination, vincristine-doxorubicin-cyclophosphamide, was administered as secondary therapy. Tumor-containing specimens were collected from 60 of the 80 patients, (75%). One or more cell lines were established from 28 patients, and DST data were available from 26 patients (33% of total). Several parameters of in vitro drug sensitivity were significantly associated (two-sided P (P2 <.05) with clinical response to primary therapy and also with response to the IVBR and were marginally associated with length of survival (.07 ≤ P2 .08). Sixteen patients (23%) received their IVBR as secondary therapy, and four of these (25%) attained a complete response, compared with three of 43 (7%) who received an empiric regimen (P2=.16). We concluded that (a) selection of individualized chemotherapy is labor intensive but feasible in extensive-stage SCLC; (b) DST data are associated with clinical response to primary therapy and to secondary therapy with an IVBR; and (c) further observations will be required if we are to determine whether there is a modest therapeutic benefit to administering the IVBR as a secondary therapy. [J Natl Cancer Inst 82: 117-124, 1990] © 1990 Oxford University Press.
引用
收藏
页码:117 / 124
页数:8
相关论文
共 20 条
  • [11] NONPARAMETRIC-ESTIMATION FROM INCOMPLETE OBSERVATIONS
    KAPLAN, EL
    MEIER, P
    [J]. JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION, 1958, 53 (282) : 457 - 481
  • [12] MDR1 GENE-EXPRESSION IN LUNG-CANCER
    LAI, SL
    GOLDSTEIN, LJ
    GOTTESMAN, MM
    PASTAN, I
    TSAI, CM
    JOHNSON, BE
    MULSHINE, JL
    IHDE, DC
    KAYSER, K
    GAZDAR, AF
    [J]. JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1989, 81 (15) : 1144 - 1150
  • [13] MANTEL NATHAN, 1966, CANCERCHEMOTHERAP REP, V50, P163
  • [14] SMALL CELL LUNG-CANCER 1973-1983 - EARLY PROGRESS AND RECENT OBSTACLES
    MORSTYN, G
    IHDE, DC
    LICHTER, AS
    BUNN, PA
    CARNEY, DN
    GLATSTEIN, E
    MINNA, JD
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1984, 10 (04): : 515 - 539
  • [15] SIMMS E, 1980, CANCER RES, V40, P4356
  • [16] PREDICTION OF THE CLINICAL CHEMOTHERAPEUTIC RESPONSE OF STAGE-III LUNG ADENOCARCINOMA PATIENTS BY AN INVITRO SHORT-TERM TEST
    VOLM, M
    DRINGS, P
    HAHN, EW
    MATTERN, J
    [J]. BRITISH JOURNAL OF CANCER, 1988, 57 (02) : 198 - 200
  • [17] CLONES, DYES, NUCLIDES, MOUSE KIDNEYS, AND VIRIONS - A NEW-CLONOGENIC ASSAY FOR TUMOR CHEMOSENSITIVITY
    WEISENTHAL, LM
    [J]. EUROPEAN JOURNAL OF CANCER & CLINICAL ONCOLOGY, 1987, 23 (01): : 9 - 12
  • [18] WEISENTHAL LM, 1983, CANCER RES, V43, P258
  • [19] WEISENTHAL LM, 1983, CANCER RES, V43, P749
  • [20] WEISENTHAL LM, 1989, IN PRESS ADV CLIN ON