Prevalence of In Vitro Extreme Chemotherapy Resistance in Resected Nonsmall-Cell Lung Cancer

Chemotherapy, chemoresistance and the changing treatment landscape for NSCLC

“…In one study of 3042 NSCLC patient tumor cultures, extreme or intermediate resistance to carboplatin was documented in 68% (1056/1565) of samples and cisplatin resistance was documented in 63% (1409/2227) of samples [13]. Resistance to doxorubicin, etoposide, gemcitabine, vinorelbine, paclitaxel, docetaxel, and topotecan was reported in 75,63,72,42,40,52 and 31% of samples, respectively [13]. All NSCLC patients will eventually develop resistance to the chemotherapeutic agents to which they are exposed, even with a good initial response, and most will receive two or three lines of therapy.…”

In vitro extreme drug resistance assay to taxanes or platinum compounds for the prediction of clinical outcomes in epithelial ovarian cancer: a prospective cohort study

“…Besides, newly diagnosed breast cancer patients treated with agents found to be inactive in this assay have been reported to show a signiWcantly shortened progressionfree survival (PFS) and overall survival (OS) compared to those with tumors that showed low drug resistance (Mehta et al 2001). In leukemia, lung and colon cancers, in vitro EDR assay also contributed in part to therapeutic failure and relapse (Chen et al 2001;Fan et al 2004;d'Amato et al 2006).…”

Lung Cancer: Biomarkers, Tyrosine Kinase Inhibitors and Monoclonal Antibodies

“…In a study, extreme or intermediate resistance to carboplatin was documented in 68% (1056/1565) of samples and cisplatin resistance was in 63% (1409/2227) of samples. 18 Resistance to doxorubicin, etoposide, gemcitabine, vinorelbine, paclitaxel, docetaxel and topotecan was reported in 75, 63, 72, 42, 40, 52 and 31% of samples, respectively. 18 All NSCLC patients will eventually develop resistance to the chemotherapeutic agents to which they are exposed, even with a good initial response, and most will receive two or three lines of therapy.…”

“…18 Resistance to doxorubicin, etoposide, gemcitabine, vinorelbine, paclitaxel, docetaxel and topotecan was reported in 75, 63, 72, 42, 40, 52 and 31% of samples, respectively. 18 All NSCLC patients will eventually develop resistance to the chemotherapeutic agents to which they are exposed, even with a good initial response, and most will receive two or three lines of therapy. The challenge in managing patients with NSCLC is the need to establish a long-term view, taking into account the likelihood of developing chemoresistance and the effect of using an agent at each line of therapy.…”

“…Currently, there is no reliable strategy available to guide treatment selection from first-line through all subsequent lines of therapy to avoid the development of chemoresistance, although active clinical investigations are ongoing. 18 Some platinum analogs are in early clinical development including picoplatin (cisplatin analog). This agent has demonstrated clinical activity among patients with platinum-refractory SCLC in Phase II and III trials as a second-line treatment following platinum therapy.…”