Clinical usefulness of chemotherapy based on an in vitro chemosensitivity test in urothelial cancer patients.
BACKGROUND
We evaluated the clinical usefulness of individualized chemotherapy based on an in vitro chemosensitivity test, i.e., the histoculture drug response assay (HDRA), for urothelial cancer.


METHODS
62 clinically obtained cancer specimens were studied. Each specimen was tested for sensitivity to nine anticancer drugs. The antitumor effect was calculated as the inhibition rate to their control values. The HDRA effective cytotoxic drugs were selected for clinical treatment.


RESULTS
HDRA was possible in 58 out of 62 specimens (93.5%). Their chemosensitivity showed a wide variety even among the same histological category. No correlation was seen between histological grade and chemosensitivity. The effect of chemotherapy on the measurable lesions was studied in 12 patients and good clinical responses were obtained in 7 of them (58.3%). All 7 responders were the patients who received drugs predicted to be effective by HDRA. In 8 out of the 12 patients (66.7%), including 7 true-positive and 1 true-negative, HDRA correctly predlicted the clinical effect of chemotherapy.


CONCLUSIONS
The HDRA might be feasible for predicting the efficacy and, therefore, selecting the proper anticancer drug for individual patients.
Hirano
Y
Y
Department of Urology, Hamamatsu University School of Medicine, Hamamatsu City, Japan. hirano@hama-med.ac.jp
Kageyama
S
S
Ushiyama
T
T
Suzuki
K
K
Fujita
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004354:Drug Screening Assays, Antitumor; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy*; D007682:Kidney Pelvis; D008297:Male; D008875:Middle Aged; D014523:Urethral Neoplasms / Q000188:drug therapy*; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*