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Evolution and clinical application of a rapid chemosensitivity assay
Cancer
|March 15, 1985
Summary
A new rapid assay for in vitro chemosensitivity testing significantly improves upon the traditional soft agar colony-formation assay. This faster method offers higher success rates and accurate predictions of chemotherapy resistance in clinical settings.
Area of Science:
- Oncology
- Pharmacology
- Biotechnology
Background:
- The Hamburger and Salmon soft agar colony-formation assay for in vitro chemosensitivity has limitations including long turnaround times (2-3 weeks), low success rates with small specimens, and clumping artifacts causing false-negative resistance predictions.
- These limitations hinder the clinical utility of in vitro chemosensitivity testing in guiding patient treatment decisions.
Purpose of the Study:
- To develop and evaluate an improved, rapid in vitro chemosensitivity assay with a shorter turnaround time and higher success rate compared to the traditional soft agar assay.
- To assess the clinical accuracy of the new assay in predicting patient response to chemotherapy.
Main Methods:
- Developed a rapid in vitro chemosensitivity assay incorporating tritiated thymidine, with a 5-day turnaround time.
- Processed 819 tumors using the rapid assay and compared success rates with 1591 colony-formation assays.
- Correlated in vitro predictions with clinical responses in 65 cases.
Main Results:
- The rapid assay achieved an overall success rate of 59.3%, favorably comparing to the colony-formation assay's 58.2%, with better performance on small specimens.
- High success rates were observed for melanoma (76%) and ovarian cancer (75%) specimens.
- The assay demonstrated high accuracy in predicting clinical resistance (0% response to chemotherapy) and a 43% response rate for predicted sensitive tumors.
Conclusions:
- The rapid tritiated thymidine incorporation assay offers a clinically useful improvement over the soft agar colony-formation assay for in vitro chemosensitivity testing.
- This assay is particularly effective in predicting clinical resistance to chemotherapy due to the absence of clumping artifacts and the ability to use peak drug concentrations.
- Continuous evolution of in vitro chemosensitivity testing is crucial for maximizing clinical application and improving patient outcomes.