Ann Surg Treat Res.  2019 Aug;97(2):93-102. 10.4174/astr.2019.97.2.93.

Clinical value of an adenosine triphosphate-based chemotherapy response assay in resectable stage III colorectal cancer

• Kim CD
• Kim SH
• Jung SH
• Kim JH

• KMID: 2455983
• DOI: http://doi.org/10.4174/astr.2019.97.2.93

Abstract

PURPOSE
ATP-based chemotherapy response assay (ATP-CRA) is a well-documented and validated technology that can individualize chemotherapy. This study was undertaken to assess the usefulness of ATP-CRA in advanced colorectal cancer (CRC) patients receiving adjuvant chemotherapy.
METHODS
A total of 136 patients with curative resection between January 2006 and April 2014 were evaluated using ATP-CRA. Patients received either the FOLFOX or Mayo clinic regimen chemotherapy following assay results. The sensitive-group (S-group) was defined as a drug-producing ≥ 40% reduction in ATP, and the resistant-group (R-group) as an ATP reduction of < 40%. These 2 groups were further subdivided to produce 4 subgroups: the FOLFOX sensitive subgroup (the FS subgroup [n = 65]), the Mayo sensitive subgroup (the MS subgroup [n = 40]), the FOLFOX resistant subgroup (the FR subgroup [n = 10]), and the Mayo resistant subgroup (the MR subgroup [n = 21]). Clinical responses and survival results were compared for both treatment regimens.
RESULTS
The FS and MS subgroups showed a better disease-free survival rate (29% vs. 40%, 35% vs. 47.6%) and overall survival rate (92.3% vs. 80.0%, 87.5% vs. 76.2%) than FR and MR subgroups. The FS and MS subgroups showed a longer time to relapse (20.2 months vs. 9.5 months, 17.6 months vs. 16.4 months) than the FR and MR subgroups.
CONCLUSION
ATP-CRA tailored-chemotherapy has the potential to provide a survival benefit in resectable advanced CRC.

Keyword

Adenosine triphosphate; Antitumor drug screening assays; Colorectal neoplasms; FOLFOX regimen; Adjuvant chemotherapy

MeSH Terms

Adenosine Triphosphate
Adenosine*
Chemotherapy, Adjuvant
Colorectal Neoplasms*
Disease-Free Survival
Drug Screening Assays, Antitumor
Drug Therapy*
Humans
Recurrence
Survival Rate
Adenosine
Adenosine Triphosphate

Figure

• 

  Fig. 1 Flow chart demonstrating patient selection, treatment selection. S-group, sensitive-group; R-group, resistant-group; DFS, disease-free survival; OS, overall survival.

• 

  Fig. 2 (A) Disease-free survival rate according to the chemosensitivity test results for all study subjects. (B) Overall survival rates according to chemosensitivity test results for all study subjects. S-group, sensitive-group; R-group, resistant-group.

• 

  Fig. 3 (A) Disease-free survival rates according to chemosensitivity test results for FOLFOX. (B) Overall survival rates according to chemosensitivity test results for FOLFOX. S-group, sensitive-group; R-group, resistant-group.

• 

  Fig. 4 (A) Disease-free survival rates according to chemosensitivity test results for Mayo. (B) Overall survival rates according to chemosensitivity test results for Mayo. S-group, sensitive-group; R-group, resistant-group.

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