Eur J Gynaecol Oncol 2001;22(4):278-82
Chemosensitivity testing predicts survival in ovarian cancer.
Taylor CG, Sargent JM, Elgie AW, Williamson CJ, Lewandowicz GM, Chappatte
O, Hill JG.
Haematology Research, Pembury Hospital, Kent, UK.
The aim of this study was to assess the use of the MTT assay for chemosensitity
testing to identify drug resistance and predict survival in patients with
advanced ovarian cancer. Samples of ascitic fluid and/or solid biopsies
were taken from 120 patients with FIGO stage III or IV ovarian adenocarcinoma
at presentation. Cells were exposed for 48 hours to four concentrations
of clinically relevant drugs including platinums, anthracyclines and alkylating
agents. Cell survival was measured using the 3-4,5-dimethyl-2, 5-diphenyl
tetrazolium bromide (MTT) assay allowing patients to be grouped as "sensitive"
or "resistant" in vitro. Clinical data including age, residual
disease, histological grade, treatment, response after initial treatment
and overall survival were collected. There was a highly significant (p<0.0001)
correlation of in vitro sensitivity with in vivo response in the patients
who completed their therapy, with an 83% positive predictive accuracy for
resistance. This translated in the longer term to an increased survival
for the patients found to be sensitive in vitro to their therapy with a
5-year survival rate of 24% compared to 12% for the resistant group (p=0.033).
These results suggest that MTT chemonsensitivity testing can predict response
in ovarian cancer leading to the prospect of increased survival in this
devastating disease by customising therapy to individual patients.