Individualized chemotherapy for colorectal cancer based on the collagen gel droplet-embedded drug sensitivity test

Ochiai,Takumi; Nishimura,Kazuhiko; Watanabe,Tomoo; Kitajima,Masayuki; Nakatani,Akinori; Inou,Takashi; Washio,Marie; Sakuyama,Naoki; Sato,Tsuyoshi; Kishine,Kenji; Ochi,Takanori; Okubo,Satoshi; Futagawa,Shunji; Mashiko,Satomi; Nagaoka,Isao

doi:10.3892/ol.2012.823

Individualized chemotherapy for colorectal cancer based on the collagen gel droplet-embedded drug sensitivity test

Authors:
- Takumi Ochiai
- Kazuhiko Nishimura
- Tomoo Watanabe
- Masayuki Kitajima
- Akinori Nakatani
- Takashi Inou
- Marie Washio
- Naoki Sakuyama
- Tsuyoshi Sato
- Kenji Kishine
- Takanori Ochi
- Satoshi Okubo
- Shunji Futagawa
- Satomi Mashiko
- Isao Nagaoka
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Affiliations: Department of Surgery, Tobu Chiiki Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, Tokyo, Japan, Department of Pharmacy, Tobu Chiiki Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, Tokyo, Japan, Department of Host Defense and Biochemical Research, Juntendo University School of Medicine, Tokyo, Japan
Published online on: July 25, 2012 https://doi.org/10.3892/ol.2012.823
Pages: 621-624

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Abstract

The leucovorin (FOL) and fluorouracil (5-FU) plus oxaliplatin (l-OHP; FOLFOX) or FOL and 5-FU plus irinotecan (SN-38; FOLFIRI) regimens with or without molecularly‑targeted drugs are widely used as first-line chemotherapy in the treatment of advanced colorectal cancer (CRC). Whether FOLFOX or FOLFIRI is administered first is not significant, however, it is essential that full administration of the targeted dosages of all 3 drugs, 5-FU, l-OHP and SN-38, is achieved. However, this is not always possible and second‑line chemotherapy must be abandoned in certain cases. Where possible, the most effective regimen should be selected as the first line of treatment. The aim of this study was to determine whether first-line chemotherapy may be individualized using the collagen gel droplet-embedded drug sensitivity test (CD-DST). Specimens of primary tumors were obtained from 43 CRC patients who had received no preoperative chemotherapy. Informed consent to measure drug sensitivity was obtained from all patients. The CD-DST allows evaluation of drug sensitivity using isolated, 3-dimensionally cultured tumor cells in a small collagen gel droplet. The CD-DST was performed and the growth inhibition rate (IR) was obtained under incubation conditions (5-FU with l-OHP at 6.0 and 3.0 µg/ml, or 5-FU with SN-38 at 6.0 and 0.2 µg/ml, respectively, for 24 h). The cumulative distributions of the growth IRs under each condition were evaluated based on the evidence that the clinical response rates to FOLFOX and FOLFIRI were almost the same. Individualization of first-line treatment was possible in all patients, with FOLFOX and FOLFIRI showing higher efficacy in 26 and 15 patients, respectively, and equal efficacy in 2 cases. This method has the potential to facilitate the establishment of individualized first-line chemotherapy for CRC and improve the prognosis in such patients.

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