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Individualized Tumor Response Testing for Prediction of Response to Paclitaxel and Cisplatin Chemotherapy in Patients with Advanced Gastric Cancer

Authors
Kim, Jee HyunLee, Keun-WookKim, Yeul HongLee, Kyung HeeOh, Do YounKim, JoonheeYang, Sung HyunIm, Seock-AhChoi, Sung HoBang, Yung-Jue
Issue Date
5월-2010
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Stomach neoplasms; Antineoplastic Agents; Therapeutic Use; Drug Screening Assays, Antitumor; Paclitaxel; Cisplatin; Sensitivity and Specificity
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.25, no.5, pp.684 - 690
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
25
Number
5
Start Page
684
End Page
690
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/116494
DOI
10.3346/jkms.2010.25.5.684
ISSN
1011-8934
Abstract
The purpose of our study was to determine the most accurate analytic method to define in vitro chemosensitivity, using clinical response as reference standard in prospective clinical trial, and to assess accuracy of adenosine triphosphate-based chemotherapy response assay (ATP-CRA). Forty-eight patients with chemo-naive, histologically confirmed, locally advanced or metastatic gastric cancer were enrolled for the study and were treated with combination chemotherapy of paclitaxel 175 mg/m(2) and cisplatin 75 mg/m2 for maximum of six cycles after obtaining specimen for ATP-CRA. We performed the receiver operator characteristic curve analysis using patient responses by WHO criteria and ATP-CRA results to define the method with the highest accuracy. Median progression free survival was 4.2 months (95% confidence interval [CI]: 3.4-5.0) and median overall survival was 11.8 months (95% CI: 9.7-13.8) for all enrolled patients. Chemosensitivity index method yielded highest accuracy of 77.8% by ROC curve analysis, and the specificity, sensitivity, positive and negative predictive values were 95.7%, 46.2%, 85.7%, and 75.9%. In vitro chemosensitive group showed higher response rate (85.7% vs. 24.1%) (P=0.005) compared to chemoresistant group. ATP-CRA could predict clinical response to paclitaxel and cisplatin chemotherapy with high accuracy in advanced gastric cancer patients. Our study supports the use of ATP-CRA in further validation studies.
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