Predictive Value of In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay in Advanced Gastric Cancer Patients Who Received Oral 5-Fluorouracil after Curative Resection

다국어 초록 (Multilingual Abstract)

Purpose To assess the usefulness of adenosine triphosphate-based chemotherapy response assay (ATP-CRA) results in advanced gastric cancer patients receiving adjuvant chemotherapy.
Materials and Methods Sixty-two patients underwent curative surgical resection between January, 2006 and December,2008. Their highly purified surgical specimens were evaluated by ATP-CRAs. Of the 62, 49had successful assay results and they received either oral 5-fluorouracil or other chemotherapies.
We retrospectively analyzed data for 24 patients who were treated with oral 5-fluorouracil and whose assays were successful.
Results The median observation time was 24.6 months (range, 10.1 to 40.9 months). The median treatment time was 11.2 months (range, 1.2 to 17.7 months). The median age was 66 years (range, 30 to 81 years). Patients were grouped into sensitive- and resistant-groups according to adenosine triphosphate-based chemotherapy response results for fluorouracil. The sensitivegroup showed a significantly longer time to relapse (not reached in the sensitive-group vs.
24.8 months in the resistant-group, p=0.043) and longer overall survival compared to the resistant-group (not reached in the sensitive-group vs. 35.7 months in the resistant-group,p=0.16, statistically insignificant).
Conclusion Patients who receive curative surgical resection significantly benefit from sensitive adjuvant chemotherapy according to ATP-CRA results for time to relapse.

참고문헌 (Reference)

1 Nakamura R, "Role of the MTT chemosensitivity test in the prognosis of gastric cancer patients after postoperative adjuvant chemotherapy" 26 : 1433-1437, 2006

2 Han SS, "Predictive value of individualized tumor response testing by ATP-based chemotherapy response assay in ovarian cancer" TAYLOR & FRANCIS INC 26 : 426-430, 2008

3 Okines AF, "Meta-analysis of the REAL-2 and ML17032 trials: evaluating capecitabine-based combination chemotherapy and infused 5-fluorouracil-based combination chemotherapy for the treatment of advanced oesophago-gastric cancer" 20 : 1529-1534, 2009

4 Gianni L, "Meta-analyses of randomized trials of adjuvant chemotherapy in gastric cancer" 12 : 1178-1180, 2001

5 Parkin DM, "Global cancer statistics" 49 : 33-64, 1999

6 Rich TA, "Four decades of continuing innovation with fluorouracil: current and future approaches to fluorouracil chemoradiation therapy" 22 : 2214-2232, 2004

7 Mari E, "Efficacy of adjuvant chemotherapy after curative resection for gastric cancer: a meta-analysis of published randomised trials. A study of the GISCAD (Gruppo Italiano per lo Studio dei Carcinomi dell’Apparato Digerente)" 11 : 837-843, 2000

8 Shirasaka T, "Development of a novel form of an oral 5-fluorouracil derivative (S-1) directed to the potentiation of the tumor selective cytotoxicity of 5-fluorouracil by two biochemical modulators" 7 : 548-557, 1996

9 Roukos DH, "Current status and future perspectives in gastric cancer management" 26 : 243-255, 2000

10 Cree IA, "Correlation of the clinical response to chemotherapy in breast cancer with ex vivo chemosensitivity" 7 : 630-635, 1996

11 Woo SU, "Correlation between the in vitro ATP-based chemosensitivity assay and HER2/neu expression in women with breast cancer" FIELD HOUSE PUBLISHING LLP 35 : 753-761, 2007

12 Kim R, "Chemosensitivity testing for gastrointestinal cancer: survival benefit potential and limitations" 14 : 715-723, 2003

13 Van Cutsem E, "Capecitabine, an oral fluoropyrimidine carbamate with substantial activity in advanced colorectal cancer: results of a randomized phase II study" 18 : 1337-1345, 2000

14 Kubota T, "Cancer chemotherapy chemosensitivity testing is useful in evaluating the appropriate adjuvant cancer chemotherapy for stages III/IV gastric cancers without peritoneal dissemination" 23 : 583-587, 2003

15 Kubota T, "Cancer chemosensitivity test: from laboratory to clinic" 8 : 189-194, 1995

16 Greene FL, "American Joint Committee on Cancer Staging manual" Springer 2002

17 Ron IG, "Advanced colorectal carcinoma: redefining the role of oral ftorafur" 7 : 649-654, 1996

18 Nakajima T, "Adjuvant mitomycin and fluorouracil followed by oral uracil plus tegafur in serosanegative gastric cancer: a randomised trial. Gastric Cancer Surgical Study Group" 354 : 273-277, 1999

19 Macdonald JS, "Adjuvant chemotherapy with 5-FU, adriamycin, and mitomycin-C (FAM) versus surgery alone for patients with locally advanced gastric adenocarcinoma: A Southwest Oncology Group study" 2 : 488-494, 1995

20 Moon YW, "Adenosine triphosphate- based chemotherapy response assay (ATP-CRA)-guided platinum-based 2-drug chemotherapy for unresectable nonsmall-cell lung cancer" 109 : 1829-1835, 2007