Sensitivity Assessment of Chemotherapeutic Agents for Ovarian Tumors Based on Test in Vitro Culture: A Blind Study

Abstract

Background: Ovarian cancer is common malignant tumors but the survival rate has not been improved well for a long time. One of the important reasons is that the current clinical guidelines for treatment still do not solve the problem of patient heterogeneity and drug resistance, which are exactly the key factors affecting the efficacy of chemotherapy. In addition, there are limited research data that can help accurately identify patients' preferred drugs and combination regimen, which fails to meet the needs of individualized treatment. Methods：The objective was used the Hydrogel Embedded Histoculture Drug Sensitivity Test (HDST), to verified its accuracy in predicting the response to chemotherapy in ovarian tumors and evaluate the sensitivity of chemotherapy drugs. Tissue samples of 82 ovarian tumor patients were tested for HDST drug sensitivity and follow-up who were included in randomized study. The consistency of drug sensitivity results and clinical outcomes were analyzed through preliminary study to determine the feasibility of this technology, and then a comprehensive blind study was conducted to evaluate Drug sensitivity.Result: HDST in determining the efficacy of chemotherapy drugs were consistent with the actual clinical efficacy of patients (Kappa=0.535), and the sensitivity, specificity, AUC were 82.14%, 100.00%, 0.911. Single-drug resistance rates of TXL, DOC, CDDP, CBP, Lobaplatin, and VP-16 were 21.95%, 74.39%, 62.20% , 52.44%, 39.02%, 60.98%, respectively. Highest Secondary drug resistance rate of CBP was 44.44%, followed by CDDP and VP-16 (22.22%). TXL’s IR was significantly higher than DOC wherever the location, and Loplatin’s was higher than CDDP (P<0.05). TXL’s IR was higher than VP-16 in primary foci, but VP-16’s was not only higher than DOC, but also CDDP, and similar to the CBP and Lobaplatin in abdominal metastases(P<0.05).Conclusion: HDST can effectively predict the response to existing chemotherapy regimens as new tool to screen individualized treatment for patients. Paclitaxel combined with Lobaplatin regimen may have more advantages in chemotherapy and Etoposide should not be ignored in ovarian tumors.