Development and Applicability of Integrative Tumor Response Assays for Metastatic Colorectal Cancer.
The present study investigated how well the results of integrative tumor-response assay (ITRA) compared to those of clinical response to chemotherapy in patients with metastatic colorectal cancer (CRC).



A total of 129 patients with metastatic CRC were prospectively enrolled. ITRA consisted of two sequential histoculture drug-response assays (HDRAs). First-stage HDRAs were performed using 5-fluorouracil with leucovorin and oxaliplatin (FX), or with irinotecan (FR). Second-stage HDRAs (ITRA) were performed for cells surviving after the first-stage HDRA, using FX, FR, and their combinations with bevacizumab and cetuximab.



Among 129 patients, 42 (32.6%) completed second-line chemotherapy, results that correlated with those of ITRA. The accuracy of ITRA for predicting response to second-line chemotherapy was 61.9% (26/42), with a sensitivity of 44.4% (8/18) and a specificity of 75% (18/24).



Despite its relatively low accuracy, ITRA might be a useful technique for predicting therapeutic efficacy and selecting for appropriate first-line and second-line anticancer regimens for patients.
Department of Surgery, University of Ulsan College of Medicine, Seoul, Republic of Korea.|Institute of Innovative Cancer Research, Asan Medical Center, Seoul, Republic of Korea.
Yong Sik
YS
Yoon
Department of Surgery, University of Ulsan College of Medicine, Seoul, Republic of Korea.|Institute of Innovative Cancer Research, Asan Medical Center, Seoul, Republic of Korea.
Chan Wook
CW
Kim
Institute of Innovative Cancer Research, Asan Medical Center, Seoul, Republic of Korea.
Seon Ae
SA
Roh
Institute of Innovative Cancer Research, Asan Medical Center, Seoul, Republic of Korea.|Graduate School of East-West Medical Science, Kyung Hee University, Gyeonggi-do, Republic of Korea.
Dong Hyung
DH
Cho
Institute of Innovative Cancer Research, Asan Medical Center, Seoul, Republic of Korea.|Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Tae Won
TW
Kim
Institute of Innovative Cancer Research, Asan Medical Center, Seoul, Republic of Korea.
Moon Bo
MB
Kim
Department of Surgery, University of Ulsan College of Medicine, Seoul, Republic of Korea jckim@amc.seoul.kr.|Institute of Innovative Cancer Research, Asan Medical Center, Seoul, Republic of Korea.
Jin Cheon
JC
Kim
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000378:metabolism*; D004354:Drug Screening Assays, Antitumor / Q000379:methods*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
Colorectal adenocarcinoma; chemotherapy; histoculture drug-response assay; molecular targeted therapy; treatment outcome