A new in-vitro drug sensitivity test (collagen-gel droplet embedded-culture drug sensitivity test) in carcinomas of pancreas and biliary tract: possible clinical utility

Abstract

The collagen-gel droplet embedded-culture drug sensitivity test (CD-DST), a chemosensitivity test, evaluate the efficacy of anticancer drugs and to was used clinically to thus plan rational postoperative chemotherapy for patients with pancreatic and biliary tract carcinomas. The CD-DST solves some problems inherent in other conventional assays. This method: (1) allows evaluation of four chemotherapeutic agents, using small quantities of cells (1 x 10(5) cells), (2) shows high primary culture success rates, (3) maintains the original growth characteristics of the cultured cells, (4) eliminates the effects of fibroblasts by employing image analysis, and (5) permits evaluation using physiologic drug concentrations. Primary cultures of tumor cell samples from all 25 patients with pancreatic or biliary tract carcinomas studied were successful. Against pancreatic carcinomas, the efficacy rates, assessed by CD-DST, of four anticancer drugs evaluated were: 25.0% for mitomycin (MMC), followed by 23.5% for adriamycin, 18.8% for 5-fluorouracil (5-FU), and 11.8% for cisplatin (CDDP). Against biliary tract carcinomas, the rates were highest for 5-FU and MMC (50.0%) and lowest for CDDP (25.0%). The efficacy rates for all four anticancer drugs evaluated were higher against biliary tract carcinomas than against pancreatic carcinomas. Tumor cultures from 10 of 17 patients with pancreatic cancer and 3 of 8 patients with biliary tract cancer showed no sensitivity to any of the drugs tested. The in-vitro results with CD-DST suggest the risk of administering non-selective postoperative chemotherapy to patients with pancreatic and biliary tract carcinomas, and emphasize the importance of carefully selecting effective chemotherapeutic agents based on adequate chemosensitivity testing.

Is postoperative adjuvant chemotherapy useful for gallbladder carcinoma?

“…Results of in vitro drug sensitivity testing in the study laboratories, using the collagen gel droplet-embedded culture drug sensitivity test, have shown the efficacy of 5-FU and MMC to be 18.8% and 25.0%, respectively, in patients with pancreatic carcinoma and 50.0% and 50.0%, respectively, in patients with biliary tract carcinoma, indicating the particularly good sensitivity of biliary tract carcinoma to these agents. 29 In in vitro experiments, biliary tract carcinoma demonstrated a higher sensitivity to these agents compared with pancreatic carcinoma. Our group also has performed two randomized controlled studies of nonresected pancreaticobiliary carcinomas.…”

ATP assay-guided chemosensitivity testing for gemcitabine with biopsy specimens obtained from unresectable pancreatic cancer using endoscopic ultrasonography-guided fine-needle aspiration

“…Recently, chemosensitivity testing for treatment of gastric cancer has been approved in Japan. However, for pancreatic cancer, only one study has reported the use of chemosensitivity testing for adjuvant chemotherapy [12]. The most important reason that chemosensitivity testing has seldom been performed for pancreatic cancer is that many patients are unresectable.…”

Differences in Chemosensitivity between Primary and Metastatic Tumors in Colorectal Cancer

“…The collagen gel droplet-embedded culture drug sensitivity test (CD-DST) is an in vitro anticancer drug sensitivity test [1]–[6]. Recent studies have reported that CD-DST can provide useful therapeutic information for patients with gastric cancer, lung cancer, colorectal cancer or pancreatic cancer [7]–[12].…”