Yonsei Med J.  2014 Nov;55(6):1664-1671. 10.3349/ymj.2014.55.6.1664.

ATP-Based Chemotherapy Response Assay in Primary or Recurrent Ovarian and Peritoneal Cancer

• Lee M
• Kim SW
• Nam EJ
• Cho H
• Kim JH
• Kim YT
• Kim S

• KMID: 2070217
• DOI: http://doi.org/10.3349/ymj.2014.55.6.1664

Abstract

PURPOSE
To investigate chemosensitivity with an adenosine triphosphate-based chemotherapy response assay in patients with epithelial ovarian or peritoneal cancer according to tumor histology, grade, and disease status.
MATERIALS AND METHODS
One hundred specimens were collected during primary or secondary debulking from 67 patients with primary ovarian cancer, 24 patients with recurrent ovarian cancer, 5 patients with primary peritoneal cancer, and 4 patients with recurrent peritoneal cancer; samples were collected between August 2006 and June 2009. Tumor cells were isolated and cultured for 48 hours in media containing chemotherapy. The chemosensitivity index (CI) was calculated as 300 minus the sum of the cell death rate at 0.2x, 1x, and 5x drug concentrations, and the CI values were compared.
RESULTS
CI values were obtained from 93 of 100 patients. The most active agents against primary disease were ifosfamide and paclitaxel. For primary serous adenocarcinoma, paclitaxel and irinotecan were the most active, followed by ifosfamide. For clear cell carcinoma, ifosfamide was the most active, followed by paclitaxel and irinotecan. Although not statistically significant, the CIs of cisplatin, carboplatin, paclitaxel, and docetaxel decreased as tumor grade increased. In 14 cases of recurrent disease, paclitaxel was the most active, followed by ifosfamide and cisplatin.
CONCLUSION
Ifosfamide and paclitaxel were the most active drugs for primary and recurrent disease. Therefore, we recommend further clinical studies to confirm the efficacy of paclitaxel, ifosfamide, and cisplatin combination chemotherapy for recurrent and primary ovarian cancer.

Keyword

Adenosine triphosphate; cell death; drug therapy; combination; ovarian cancer

MeSH Terms

Adenocarcinoma, Clear Cell/*drug therapy/metabolism/pathology
Adenosine Triphosphate/*metabolism
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
Camptothecin/administration & dosage/analogs & derivatives
Carboplatin/therapeutic use
Cisplatin/administration & dosage
Drug Resistance, Neoplasm
Drug Screening Assays, Antitumor/methods
Female
Humans
Ifosfamide/administration & dosage
Middle Aged
Neoplasm Recurrence, Local/*drug therapy
Neoplasms, Glandular and Epithelial/*drug therapy/metabolism/pathology
Ovarian Neoplasms/*drug therapy/metabolism/pathology
Paclitaxel/therapeutic use
Peritoneal Neoplasms/*drug therapy/metabolism/pathology
Predictive Value of Tests
Sensitivity and Specificity
Taxoids/administration & dosage
Adenosine Triphosphate
Camptothecin
Carboplatin
Cisplatin
Ifosfamide
Paclitaxel
Taxoids

Figure

• 

  Fig. 1 Box-and-whisker plots of the CI rank of 10 chemotherapeutic agents in primary (A) and recurrent disease (B). The bottom and top edges of the box represent the 25th and 75th percentiles, respectively, whereas the horizontal line corresponds to the median value. The vertical lines show the range of values. The agents that were ranked with the first and second CI values in primary and recurrent disease were paclitaxel and ifosfamide. CI, chemosensitivity index.

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