A Southwest Oncology Group study on the use of a human tumor cloning assay for predicting response in patients with ovarian cancer

Article Abstract:

Despite gains in chemotherapy for cancer, some fraction of patients will relapse or fail to respond to treatment. It would, of course, be useful to predict in advance which chemotherapeutic regimens would be unlikely to work and which would have the greatest chance of success. In the case of advanced ovarian cancer, only from 10 to 40 percent of patients may be expected to achieve a complete response, and the outlook for those who fail to respond or who relapse is grim. One method of potential usefulness in the prediction of response to chemotherapy is in vitro testing. This method involves culturing cells from a patient's tumor and then adding chemotherapeutic agents to these cells in the laboratory. It is far from certain, however, that chemotherapeutic agents which work in laboratory dishes will work in the patient as well. In order to evaluate the usefulness of tissue culture in the prediction of chemotherapeutic response, tumor cell cultures from 211 patients with epithelial ovarian cancer were cultured. In 168 patients, the cancers have proved refractory to prior chemotherapy, while in 43 patients no prior chemotherapy had been attempted. Of the 168 patients with prior chemotherapy, sensitivity of the cells to agents in tissue culture could be demonstrated in 23. These patients were treated with the same agents. For 101 patients, either cell cultures could not be successfully established or no sensitivity in culture could be demonstrated. These patients were treated with a chemotherapeutic agent of the physician's choice. The remaining patients were not treated due to either deterioration or death. Among the patients treated with the agents demonstrated to work in tissue culture, the response rate was 28 percent, in contrast to 11 percent for the remainder. However, this response rate did not translate into an improvement in survival, which was a median of 6.7 and 7.0 months for the two groups, respectively. For the patients who had never been treated, only seven cultures could be established, but among these the correlation between in vitro sensitivity and response to treatment was perfect. The results show that the technique shows some promise, but that it is at present severely limited by the difficulty in establishing successful cultures for the majority of patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ovarian cancer, Tissue culture

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The concept of locally advanced gastric cancer: effect of treatment on outcome

Article Abstract:

When stomach cancer has spread locally to the point where surgical removal is not feasible, chemotherapy remains the practical alternative. In a previous study, researchers found evidence to suggest that the addition of radiotherapy may provide added benefit. The results of this study were not entirely satisfactory. While a greater proportion of patients treated with both radiotherapy and chemotherapy were alive after four years compared with patients treated with chemotherapy alone, half the patients treated with combined therapy died more rapidly than those treated only with chemotherapy. Average survival was 40 and 76 weeks. Autopsy evidence suggested that some of the patients succumbed to problems of weakness associated with nutrition rather than from progression of the cancer. It was thought a modification of the treatment schedule might effect the long-term survival modality treatment, while reducing the number of early deaths. A combination of doxorubicin, 5-fluorouracil, and methyl-CCNU was given prior to radiotherapy. A total of 90 patients began the trial and were randomized to receive chemotherapy alone or chemotherapy with radiation. The average survival of the chemotherapy-only group was 59 weeks, and three-year survival was 11 percent for patients treated with three-drug chemotherapy regimen. Of the 44 evaluable cases for the chemotherapy and radiotherapy group, average survival was 62 weeks, with only 7 percent alive after three years. These data tend to explain the early deaths in the combined modality group, but long-term survival with combination therapy has not been demonstrated in this study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Stomach cancer

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Development of postoperative intrathoracic chemothermotherapy for lung cancer with objective of improving local cure

Article Abstract:

In many cases of lung cancer, surgery cannot eradicate the tumor due to its spread to the pleura (lining between lungs and chest wall). Chemotherapy is then used, and a technique has been developed in which the chest wall of post-surgical patients is heated during infusion of cisplatin, an anti-cancer drug, into the pleural space. Heating is used because chemotherapeutic drugs are more effective at higher temperatures. Using a device that generates heat electrically, the temperature inside the chest wall was successfully raised in 13 of 20 patients. The treatment was limited in seven patients by obesity, pain, skin burn, or kidney toxicity related to chemotherapy. Patients were followed up to 24 months; 14 patients were alive and free from disease at 6 to 20 months, and 1 patient was alive with disease at 23 months. Of the 8 deaths, only one had local (lung or chest) recurrence while the rest were in distant (non-chest) sites. A total of three patients had local recurrence, and none of these had completed the total course of chemothermotherapy. Survival of the entire group was better than that of an earlier group of patients treated with surgery alone, where 59 percent died. Comparisons to patients treated with chemotherapy without heating were not made. The study suggests that chemothermotherapy may be beneficial in treatment of pleural cancer; further study is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Lung cancer

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