A feasibility study of adenosine triphosphate-based chemotherapy response assay (ATP-CRA) as a chemosensitivity test for lung cancer

Abstract

Purpose: A chemosensitivity test can reflect the differences in responses of individual cancer patients to chemotherapeutic agents. The adenosine triphosphate-based chemotherapy response assay (ATP-CRA) is an accurate method, which does not require a large amount of tissue specimen. So far, no studies have evaluated the utility of the ATP-CRA in Korea. Therefore, we investigated the clinical usefulness of the ATP-CRA in 53 patients with lung cancer.

Materials and methods: Tumor tissues were obtained from bronchoscopic biopsies or surgical resections. The validity of ATP-CRA was assessed focusing on the success rate, experimental error level (intraassay mean coefficient of variation [CV]) and reproducibility.

Results: The overall success rate of ATP-CRA was 90.6% (48/53). Normal cells were effectively eliminated from the tumor tissues with the use of ficoll gradient centrifugation and immunomagnetic separation, which was confirmed using loss of heterozygosity analysis of the 3p deletion. The mean CV of ATP assays was 10.5+/-4.6%. The reproducibility of ATP assays was 94+/-3.8%. The results of the ATP assays were reported to physicians within 7 days of specimen collection. More than 6 anticancer drugs were tested on the tumor specimens obtained from bronchoscopic biopsies.

Conclusion: The ATP-CRA is a stable, accurate and potentially practical chemosensitivity test in patients with lung cancer.

Keywords: ATP-CRA; Chemosensitivity test; Lung cancer.

Fig. 1

3p deletion analysis according to the cancer cell fractionation. 3p deletion analysis was performed using D3S1611 in patient 2. The degree of 3p deletion increased according to the immunomagnetic separation. This result indicates that adequate cancer cell fractionation was achieved.

Fig. 2

Cytotoxic effect of 7 anticancer drugs. A scatter gram shows the heterogeneity of the chemosensitivity for anticancer drugs in the indicated number of lung cancer patients. A broad range of chemosensitivity to the same concentration of anticancer drug was noted.