title: In vitro chemo-sensitivity assay guided chemotherapy is associated with prolonged overall survival in cancer patients.
abstract: OBJECTIVE
  The overall survival (OS) of patients suffering From various tumour entities was correlated with the results of in vitro-chemosensitivity assay (CSA) of the in vivo applied drugs.
  
  
  METHODS
  Tumour specimen (n=611) were dissected in 514 patients and incubated for primary tumour cell culture. The histocytological regression assay was performed 5 days after adding chemotherapeutic substances to the cell cultures. n=329 patients undergoing chemotherapy were included in the in vitro/in vivo associations. OS was assessed and in vitro response groups compared using survival analysis. Furthermore Cox-regression analysis was performed on OS including CSA, age, TNM classification and treatment course.
  
  
  RESULTS
  The growth rate of the primary was 73-96% depending on tumour entity. The in-vitro response rate varied with histology and drugs (e.g. 8-18% for methotrexate and 33-83% for epirubicine). OS was significantly prolonged for patients treated with in vitro effective drugs compared to empiric therapy (log-rank-test, p=0.0435). Cox-regression revealed that application of in vitro effective drugs, residual tumour and postoperative radiotherapy determined the death risk independently.
  
  
  CONCLUSIONS
  When patients were treated with drugs effective in our CSA, OS was significantly prolonged compared to empiric therapy. CSA guided chemotherapy should be compared to empiric treatment by a prospective randomized trial.
authors.forename: Andrej
authors.initials: A
authors.lastname: Udelnow
authors.forename: Manfred
authors.initials: M
authors.lastname: Schönfęlder
authors.forename: Peter
authors.initials: P
authors.lastname: Würl
authors.forename: Zuhir
authors.initials: Z
authors.lastname: Halloul
authors.forename: Frank
authors.initials: F
authors.lastname: Meyer
authors.forename: Hans
authors.initials: H
authors.lastname: Lippert
authors.forename: Paweł
authors.initials: P
authors.lastname: Mroczkowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality; D004067:Digestive System Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D004354:Drug Screening Assays, Antitumor / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012509:Sarcoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D014407:Tumor Cells, Cultured / Q000187:drug effects