In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay as a Predictor of Clinical Response to Fluorouracil-Based Adjuvant Chemotherapy in Stage II Colorectal Cancer.
OBJECTIVE
We evaluated the usefulness of the in vitro adenosine triphosphate-based chemotherapy response assay (ATP-CRA) for prediction of clinical response to fluorouracil-based adjuvant chemotherapy in stage II colorectal cancer.


METHODS
Tumor specimens of 86 patients with pathologically confirmed stage II colorectal adenocarcinoma were tested for chemosensitivity to fluorouracil. Chemosensitivity was determined by cell death rate (CDR) of drug-exposed cells, calculated by comparing the intracellular ATP level with that of untreated controls.


RESULTS
Among the 86 enrolled patients who underwent radical surgery followed by fluorouracil-based adjuvant chemotherapy, recurrence was found in 11 patients (12.7%). The CDR ≥ 20% group was associated with better disease-free survival than the CDR < 20% group (89.4% vs. 70.1%, p=0.027). Multivariate analysis showed that CDR < 20% and T4 stage were poor prognostic factors for disease-free survival after fluorouracil-based adjuvant chemotherapy.


CONCLUSIONS
In stage II colorectal cancer, the in vitro ATP-CRA may be useful in identifying patients likely to benefit from fluorouracil-based adjuvant chemotherapy.
Department of Surgery, Sahmyook Medical Center, Seoul, Korea.
Hye Youn
HY
Kwon
Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Im-Kyung
IK
Kim
Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Jeonghyun
J
Kang
Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Seung-Kook
SK
Sohn
Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Kang Young
KY
Lee
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000255:Adenosine Triphosphate / Q000378:metabolism; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002272:Carcinoembryonic Antigen / Q000097:blood; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D004354:Drug Screening Assays, Antitumor / Q000379:methods; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011446:Prospective Studies; D012007:Rectum / Q000473:pathology; D014057:Tomography, X-Ray Computed
D000964:Antimetabolites, Antineoplastic; D002272:Carcinoembryonic Antigen; D000255:Adenosine Triphosphate; D005472:Fluorouracil
Adjuvant chemotherapy; Antitumor drug screening assays; Colorectal neoplasms