Abstract
Background The morbidity and mortality of gastric cancer are high in China. There are challenges to develop precise and individualized drug regimens for patients with gastric cancer after a standard treatment. Choosing the most appropriate anticancer drug after a patient developing drug resistance is very important to improve the patient's prognosis. MiniPDX has been widely used as a new and reliable preclinical research model to predict the sensitivity of anticancer drugs. Methods The OncoVee® MiniPDX system developed by Shanghai LIDE Biotech Co., Ltd. was used to establish the MiniPDX models using specimens of patients with gastric cancer. The cancer tissues were biopsied under endoscopy, and then, the tumor cell suspension was prepared for a drug sensitivity test by subcutaneously implanting into Balb/c-nude mice. The selected optimal regimen obtained from the MiniPDX assay was used to treat patients with drug-resistant gastric cancer. Results We successfully established an individualized and sensitive drug screening system for four patients from January 2021 to July 2021. MiniPDX models identified potentially effective drugs for these four patients, with partial remission in two of the patients after treatment and disease progression in the remaining of two patients. Severe side effects from chemotherapy or targeted therapy were not observed in all patients. Conclusion Establishing a personalized drug screening system for patients with drug-resistant gastric cancer can guide the selection of clinical drugs, improve the clinical benefit of patients, and avoid ineffective treatments. It can be an effective supplement for treatment options.
Highlights
Gastric cancer is one of the most common malignancies worldwide and the fourth leading cause of cancer-related death [1]. e disease generally carries a dismal prognosis due to its advanced stage at initial diagnosis. e median survival rate is less than 12 months for patients at the advanced stage [2]
Before constructing the mouse models, we conducted in-depth communication with patients and their families, and each patient signed an informed consent form. e four patients with advanced gastric cancer have progressed after previous treatment, and there was no precise and effective plan to guide their subsequent treatment
Sintilimab combined with XELOX (L-OHP combined with capecitabine) was used as the first-line treatment
Summary
Gastric cancer is one of the most common malignancies worldwide and the fourth leading cause of cancer-related death [1]. e disease generally carries a dismal prognosis due to its advanced stage at initial diagnosis. e median survival rate is less than 12 months for patients at the advanced stage [2]. Except for the positive results of trastuzumab in HER2-positive advanced gastric cancer, other clinical studies on targeted drugs for the treatment of advanced gastric cancer ended in failure [4,5,6]. Erefore, in general, we have standard treatment options for the first-line treatment of advanced gastric cancer. Patient-derived xenograft (PDX) has emerged in this context and has achieved certain clinical results. It is currently the most representative animal model with human tumor genetic information [11,12,13]. Erefore, in this study, MiniPDX was used to test the specimens of gastric cancer patients who had undergone pretreatment and select the best anticancer drugs for the subsequent treatment. Based on the MiniPDX assay results, we chose the most effective tumor-inhibiting regimen to evaluate whether it can effectively inhibit tumor growth in patients
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