Chemosensitivity of lung cancer: Differences between the primary lesion and lymph node metastasis

Abstract

Abstract. In this study, chemosensitivity tests were performed on both primary lesions (Pls) and lymph node metastases (lMs) from surgically resected non-small cell lung cancer (nsclc). Differences between the results obtained were evaluated. operative specimens were obtained from 13 patients with nsclc [6 with squamous cell carcinoma (sQ) and 7 with adenocarcinoma (AD)] whose lymph nodes were confirmed to be positive for metastasis. Both the Pl and lM from the same patient were examined immediately after resection. the collagen gel droplet-embedded culture drug sensitivity test (cD-Dst) was used as the chemosensitivity test against six anticancer drugs [5-fluorouracil (5-FU), cisplatin, gemcitabine, docetaxel, vinorelbine and sn-38 (an active metabolite of irinotecan)]. When the growth rate, determined by the t/c ratio (t, signal for viable cells in the treated group and c, signal in the control) was less than 50%, the tumor cells were considered to be sensitive to the drug. only in 4 cases (2 sQ and 2 AD) was the chemosensitivity of the primary lesion identical to that of lM. In the sQ cases, chemosensitivity of the primary lesions to 5-FU tended to be consistent with that of LMs. In contrast, the primary lesions in 4 of the 7 AD cases were negative for chemosensitivity to 5-FU; however, LMs were sensitive. In many cases, the chemosensitivity of the Pls to each anticancer drug differed from that of the lMs. In conclusion, both primary and metastatic tumors should be examined to ensure maximum clinical efficacy of in vitro drug-sensitivity testing for adjuvant chemotherapy after complete resection of n1 and n2 nsclc.Introduction the effectiveness of chemotherapy directly affects the prognosis of advanced lung cancer. Adjuvant chemotherapy is expected to contribute to the improvement of the prognosis of patients who undergo curative surgical treatments. the clinical outcome of chemotherapy against non-small cell lung cancer (nsclc) has improved since new drugs have been developed and their combination therapies have been established. However, these drugs are not always equally efficacious in all NSCLC patients. A drug that has curative effects on some patients has sometimes been observed to cause only side effects in other patients. These findings suggest the need for the appropriate selection of drugs separately for each individual patient. certain in vitro chemosensitivity tests have been established for the identification of an effective anticancer drug for individual cases (1-3), and the efficacy of these assays has been described in many clinical reports on lung cancer (4-9) and other malignancies (10-15).Anticancer drugs are expected to be effective not only against primary but also against metastatic lesions. Specifically, adjuvant chemotherapy, after complete resection of lung cancer, targets putative dormant metastasis. However, in certain clinical cases the chemosensitivity of metastatic lesions differs from that of primary lesions. this appears to be normal since the pathological features of the prima...

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Gemcitabine Versus Docetaxel Plus Cisplatin as Induction Chemotherapy in Nasopharyngeal Carcinoma

“…2). Moreover, the inconsistency of chemotherapy sensitivity between the primary tumor and metastatic lymph nodes has also been reported in several other types of cancer, including lung cancer, gastric cancer, breast cancer, and colorectal cancer 21–25 …”

“…Moreover, the inconsistency of chemotherapy sensitivity between the primary tumor and metastatic lymph nodes has also been reported in several other types of cancer, including lung cancer, gastric cancer, breast cancer, and colorectal cancer. [21][22][23][24][25] It should be noted the influence of tumor volume reduction after IC on subsequent radiotherapy planning is also a key consideration in clinical practice. To evaluate whether the superiority of the GP regimen in GTVnx reduction can lead to advantages in radiotherapy planning, we compared the dosimetric parameters between the two treatment groups in the post-PSM cohort.…”

Impact of in vitro chemosensitivity test-guided platinum-based adjuvant chemotherapy on the surgical outcomes of patients with p-stage IIIA non-small cell lung cancer that underwent complete resection

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