In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay as a Predictor of Clinical Response to Fluorouracil-Based Adjuvant Chemotherapy in Stage II Colorectal Cancer

Hye Youn Kwon; Im-kyung Kim; Jeonghyun Kang; Seung-Kook Sohn; Kang Young Lee

doi:10.4143/crt.2015.140

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In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay as a Predictor of Clinical Response to Fluorouracil-Based Adjuvant Chemotherapy in Stage II Colorectal Cancer

Authors: Hye Youn Kwon ; Im-kyung Kim ; Jeonghyun Kang ; Seung-Kook Sohn ; Kang Young Lee

Citation: CANCER RESEARCH AND TREATMENT, Vol.48(3) : 970-977, 2016

Journal Title: CANCER RESEARCH AND TREATMENT

ISSN: 1598-2998

Issue Date: 2016

MeSH: Adenocarcinoma/drug therapy* ; Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery ; Adenosine Triphosphate/metabolism ; Aged ; Antimetabolites, Antineoplastic/therapeutic use* ; Carcinoembryonic Antigen/blood ; Chemotherapy, Adjuvant/methods ; Colon/pathology ; Colonoscopy ; Colorectal Neoplasms/drug therapy* ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Disease-Free Survival ; Drug Screening Assays, Antitumor/methods ; Female ; Fluorouracil/therapeutic use* ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/drug therapy* ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery ; Neoplasm Staging ; Prospective Studies ; Rectum/pathology ; Tomography, X-Ray Computed

Keywords: Adjuvant chemotherapy ; Antitumor drug screening assays ; Colorectal neoplasms

Abstract: PURPOSE: We evaluated the usefulness of the in vitro adenosine triphosphate-based chemotherapy response assay (ATP-CRA) for prediction of clinical response to fluorouracil-based adjuvant chemotherapy in stage II colorectal cancer.

MATERIALS AND METHODS: Tumor specimens of 86 patients with pathologically confirmed stage II colorectal adenocarcinoma were tested for chemosensitivity to fluorouracil. Chemosensitivity was determined by cell death rate (CDR) of drug-exposed cells, calculated by comparing the intracellular ATP level with that of untreated controls.

RESULTS: Among the 86 enrolled patients who underwent radical surgery followed by fluorouracil-based adjuvant chemotherapy, recurrence was found in 11 patients (12.7%). The CDR ≥ 20% group was associated with better disease-free survival than the CDR < 20% group (89.4% vs. 70.1%, p=0.027). Multivariate analysis showed that CDR < 20% and T4 stage were poor prognostic factors for disease-free survival after fluorouracil-based adjuvant chemotherapy.

CONCLUSION: In stage II colorectal cancer, the in vitro ATP-CRA may be useful in identifying patients likely to benefit from fluorouracil-based adjuvant chemotherapy.