Cancer Res Treat.  2016 Jul;48(3):970-977. 10.4143/crt.2015.140.

In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay as a Predictor of Clinical Response to Fluorouracil-Based Adjuvant Chemotherapy in Stage II Colorectal Cancer

• Kwon HY
• Kim IK
• Kang J
• Sohn SK
• Lee KY

• KMID: 2344070
• DOI: http://doi.org/10.4143/crt.2015.140

Abstract

PURPOSE
We evaluated the usefulness of the in vitro adenosine triphosphate-based chemotherapy response assay (ATP-CRA) for prediction of clinical response to fluorouracil-based adjuvant chemotherapy in stage II colorectal cancer.
MATERIALS AND METHODS
Tumor specimens of 86 patients with pathologically confirmed stage II colorectal adenocarcinoma were tested for chemosensitivity to fluorouracil. Chemosensitivity was determined by cell death rate (CDR) of drug-exposed cells, calculated by comparing the intracellular ATP level with that of untreated controls.
RESULTS
Among the 86 enrolled patients who underwent radical surgery followed by fluorouracil-based adjuvant chemotherapy, recurrence was found in 11 patients (12.7%). The CDR ≥ 20% group was associated with better disease-free survival than the CDR < 20% group (89.4% vs. 70.1%, p=0.027). Multivariate analysis showed that CDR < 20% and T4 stage were poor prognostic factors for disease-free survival after fluorouracil-based adjuvant chemotherapy.
CONCLUSION
In stage II colorectal cancer, the in vitro ATP-CRA may be useful in identifying patients likely to benefit from fluorouracil-based adjuvant chemotherapy.

Keyword

Colorectal neoplasms; Adjuvant chemotherapy; Antitumor drug screening assays

MeSH Terms

Adenocarcinoma
Adenosine Triphosphate
Adenosine*
Cell Death
Chemotherapy, Adjuvant*
Colorectal Neoplasms*
Disease-Free Survival
Drug Screening Assays, Antitumor
Drug Therapy*
Fluorouracil
Humans
In Vitro Techniques*
Multivariate Analysis
Recurrence
Adenosine
Adenosine Triphosphate
Fluorouracil

Figure

• 

  Fig. 1. Disease-free survival analyses according to the chemosensitivity to fluorouracil (5-FU). The 5-year disease-free survival was significantly longer in 5-FU–sensitive patients than in 5-FU–resistant patients (89.4% vs. 70.1%, p=0.027). No chemotherapy group who did not receive adjuvant chemotherapy during the study periods was extracted from our database.

• 

  Fig. 2. Disease-free survival analyses in low-risk and in high-risk stage II patients. (A) 5-Year disease-free survival rate in the low-risk stage II patients according to the chemosensitivity to fluorouracil (5-FU). (B) 5-Year disease-free survival rate in the high-risk stage II patients according to the chemosensitivity to 5-FU.

Reference

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