Abstract
PurposeWe retrospectively evaluated the in vitro chemosensitivity of primary site and metastatic site tumors in colorectal cancer.MethodsVarious resected tumor samples (33 from lymph nodes, 42 from liver, six from lung, and 68 primary tumors) were assessed via a collagen gel droplet-embedded culture drug sensitivity test to determine chemosensitivity to a single agent or a combination of agents.ResultsSensitivity to combination chemotherapy was significantly higher than that of monotherapy in the primary site group, lymph node group, and liver group. There was significant difference between chemosensitivity of primary site and that of liver metastasis in each agent (5-FU, p<0.001; SN38, p = 0.045; 5-FU/SN38, p<0.001; OHP, p = 0.037; 5-FU/OHP, p = 0.045).ConclusionsTumors showed greater in vitro chemosensitivity to combination therapy when compared with monotherapy. Further, tumors that had metastasized to the liver were more resistant to chemotherapy when compared with matched primary tumors.
Highlights
The collagen gel droplet-embedded culture drug sensitivity test (CD-DST) is an in vitro anticancer drug sensitivity test [1,2,3,4,5,6]
We previously described the clinical potential of CD-DST in patients with colorectal cancer (CRC) [12,13] in terms of identifying chemoresistant and chemosensitive tumors [12,13]
A total of 68 primary tumors were assessed, each of which was resected from the same patient in which the metastatic tumors were resected
Summary
The collagen gel droplet-embedded culture drug sensitivity test (CD-DST) is an in vitro anticancer drug sensitivity test [1,2,3,4,5,6]. Recent studies have reported that CD-DST can provide useful therapeutic information for patients with gastric cancer, lung cancer, colorectal cancer or pancreatic cancer [7,8,9,10,11,12]. We previously described the clinical potential of CD-DST in patients with colorectal cancer (CRC) [12,13] in terms of identifying chemoresistant and chemosensitive tumors [12,13]. The main treatment for metastatic CRC is chemotherapy, and recent advances in systemic chemotherapy have resulted in improved outcomes for these patients. The clinical response to chemotherapy differs when comparing primary versus metastatic tumors (e.g., in the lymph nodes, liver, or lungs), and patients with chemoresistant tumors might benefit from other types of treatment strategies [15,16,17,18,19]
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