title: Correlation of drug-induced apoptosis assay results with oncologist treatment decisions and patient response and survival.
abstract: BACKGROUND
  An observational prospective nonblinded clinical trial was performed to determine the effect of a drug-induced apoptosis assay results on treatments planned by oncologists.
  
  
  METHODS
  Purified cancer cells from patient biopsies were placed into the MiCK (Microculture Kinetic) assay, a short-term culture, which determined the effects of single drugs or combinations of drugs on tumor cell apoptosis. An oncologist received the assay results before finalizing the treatment plan. Use of the MiCK assay was evaluated and correlated with patient outcomes.
  
  
  RESULTS
  Forty-four patients with successful MiCK assays from breast cancer (n = 16), nonsmall cell lung cancer (n = 6), non-Hodgkin lymphoma (n = 4), and others were evaluated. Four patients received adjuvant chemotherapy after MiCK, and 40 received palliative chemotherapy with a median line of therapy of 2. Oncologists used the MiCK assay to determine chemotherapy (users) in 28 (64%) and did not (nonusers) in 16 patients (36%). In users receiving palliative chemotherapy, complete plus partial response rate was 44%, compared with 6.7% in nonusers (P < .02). The median overall survival was 10.1 months in users versus 4.1 months in nonusers (P = .02). Relapse-free interval was 8.6 months in users versus 4.0 months in nonusers (P < .01).
  
  
  CONCLUSIONS
  MiCK assay results are frequently used by oncologists. Outcomes appear to be statistically superior when oncologists use chemotherapy based on MiCK assay results compared with when they do not use the assay results. When available to oncologists, MiCK assay results help to determine patient treatment plans.
authors.affiliation: Wilshire Oncology Medical Group-US Oncology, La Verne, California, USA. Linda.bosserman@womgi.com
authors.forename: Linda D
authors.initials: LD
authors.lastname: Bosserman
authors.forename: Swapnil P
authors.initials: SP
authors.lastname: Rajurkar
authors.forename: Karl
authors.initials: K
authors.lastname: Rogers
authors.forename: Dirk C
authors.initials: DC
authors.lastname: Davidson
authors.forename: Michael
authors.initials: M
authors.lastname: Chernick
authors.forename: Allan
authors.initials: A
authors.lastname: Hallquist
authors.forename: Debbee
authors.initials: D
authors.lastname: Malouf
authors.forename: Cary A
authors.initials: CA
authors.lastname: Presant
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use; D017209:Apoptosis / Q000187:drug effects*; D002755:Choice Behavior; D003657:Decision Making; D018572:Disease-Free Survival; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data*; D004354:Drug Screening Assays, Antitumor / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D010820:Physicians / Q000706:statistics & numerical data*; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States
chemical_list: D000970:Antineoplastic Agents