Eiji Kawamura

The predictability of clinical antitumor effects using two distinctive in vitro chemosensitivity tests: An analysis of true positive cases

The results of two types of in vitro chemosensitivity tests, namely, the human tumor clonogenic assay (HTCA) and the succinic dehydrogenase inhibition assay (SDIA), for solid tumors, including stomach, colorectal and lung cancers, were analyzed and their correlation with clinical effects evaluated. The anticancer agents employed were mitomycin C (MMC), 5-fluorouracil (5-FU), adriamycin (ADM) and cisplatin (DDP). The evaluability rates of the assays were 54.5% for HTCA and 89.0% for SDIA. Among the 29 cases with evaluable lesions subjected to HTCA, there were 4 true positives, 9 false positives, and 16 true negatives, whereas among the 32 cases subjected to SDIA, the corresponding numbers were 2, 6, and 24, respectively. There were no false negatives for either assay, the accuracy of prediction for HTCA being 69.0% and for SDIA, 81.3%. The true positives of both assays included one complete response (CR) and five partial responses (PR), although the eventual outcome was cancer death in all cases. Interestingly, in five out of the six true positive cases, the agent involved was either ADM or DDP, both the which are usually regarded as “second line” anticancer agents for gastrointestinal carcinomas.

An elderly lung cancer patient producing CSF whose symptoms markedly improved after resection.

例は83歳女性.右肺腫瘤影と発熱, 強い炎症反応がみられたため, 肺化膿症を疑って抗生物質を強力に投与したが陰影はかえって増大し, 全身状態も悪化した。そこで根治手術を行ったところ, 術後, 炎症反応が消失したほか, 全身状態も著しく改善し, 日常生活が可能となった.病変はColonyStimulatingFactor (CSF) 産生肺癌と判明した.患者の症状が腫瘍の随伴症状と考えられる場合は, たとえ高齢者であっても積極的な手術の適応と考えられた