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http://dx.doi.org/10.5230/jgc.2010.10.4.155

In Vitro Adenosine Triphosphate Based Chemotherapy Response Assay in Gastric Cancer  

Park, Seul-Kee (Department of Surgery, Yonsei University College of Medicine)
Woo, Yang-Hee (Department of Surgery, Yonsei University College of Medicine)
Kim, Ho-Geun (Department of Pathology, Yonsei University College of Medicine)
Lee, Yong-Chan (Department of Internal Medicine, Yonsei University College of Medicine)
Choi, Sung-Ho (ISU ABXIS Co., LTD.)
Hyung, Woo-Jin (Department of Surgery, Yonsei University College of Medicine)
Noh, Sung-Hoon (Department of Surgery, Yonsei University College of Medicine)
Publication Information
Journal of Gastric Cancer / v.10, no.4, 2010 , pp. 155-161 More about this Journal
Abstract
Purpose: The purpose of this study was to investigate the reliability and the clinical applicability of the adenosine-triphosphate-based chemotherapy response assay (ATP-CRA) as a method of determining in vitro chemosensitivity in patients with gastric cancer. Materials and Methods: A total of 243 gastric cancer tissue samples were obtained from gastrectomies performed between February 2007 and January 2010. We evaluated the effectiveness of the ATP-CRA assay in determining the chemosensitivity of gastric cancer specimens using eleven chemotherapeutic agents - etoposide, doxorubicin, epirubicin, mytomicin, 5-fluorouracil, oxaliplatin, irinotecan, docetaxel, paclitaxel, methotraxate, and cisplatin - for chemosensitivity studies using ATP-CRA. We assessed the failure rate, the cell death rate, and the chemosensitivity index. Results: The failure rate of ATP-CRA was 1.6% (4/243). The mean coefficient of variation for triplicate ATP measurements was 6.5%. Etoposide showed the highest cell death rate (35.9%) while methotrexate showed the lowest (16.6%). The most active chemotherapeutic agent was etoposide, which most frequently ranked highest in the chemosensitivity test: 31.9% (51/160). Oxaliplatin was more active against early gastric cancers than advanced gastric cancers, whereas docetaxel was more active against advanced cancers. The lymph node negative group showed a significantly higher cell death rate than the lymph node positive group when treated with doxorubicin, epirubicin, and mitomycin. Conclusions: ATP-CRA is a stable and clinically applicable in vitro chemosensitivity test with a low failure rate. The clinical usefulness of ATP-CRA should be evaluated by prospective studies comparing the regimen guided by ATP-CRA with an empirical regimen.
Keywords
Stomach neoplasms; Chemosensitivity assay; ATP based chemoresponse;
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