Usefulness of anticancer drug sensitivity test (CD-DST) in predicting colorectal cancer prognosis and treatment response

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  • TAKAHASHI Kazuto
    Preparing Section for New Faculty of Medical Science, Fukushima Medical Science
  • SAITO Yasutomo
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • OGASAWARA Manami
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • NAKAGAWA Chisato
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • MORIKAWA Chise
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • SATO Takayuki
    Department of Medical Laboratory and Blood Center, Asahikawa Medical University Hospital
  • SHIMOYAMA Norihiko
    Department of Diagnostic Pathology, Hakodate Municipal Hospital

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Other Title
  • 抗がん剤感受性試験（CD-DST）による大腸がんの予後および治療効果予測の有用性
  • コウガンザイ カンジュセイ シケン(CD-DST)ニ ヨル ダイチョウ ガン ノ ヨゴ オヨビ チリョウ コウカ ヨソク ノ ユウヨウセイ

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<p>Background: The number of anticancer drug treatments has increased with the development of molecularly targeted drugs and immune checkpoint inhibitors. However, there are individual differences in the therapeutic effects of these anticancer drugs. In this study, we investigated the usefulness of CD-DST for predicting the prognosis and treatment response in colorectal cancer. Methods: We performed CD-DST in 71 colorectal cancer patients treated with postoperative chemotherapy. We then compared overall survival, median survival, two-year survival, and five-year survival between the high- and low-sensitivity groups for each pathological stage. We also evaluated the sensitivity of six different colorectal cancer cell lines to the drug cetuximab by CD-DST. Results: The overall survival of the high-sensitivity group in stage II/III tended to be longer than that of the low-sensitivity group (p = 0.162). In addition, the median survival in stage II/III was 8.6 years in the high-sensitivity group and 2.8 years in the low-sensitivity group, and the five-year survival rates were 63.6% in the high-sensitivity group and 28.6% in the low-sensitivity group. The prognosis of the high-sensitivity group tended to be better in stage II/III than in the other stages. Furthermore, a validation test of the predicted effect of cetuximab on colorectal cancer cell lines showed that only Caco-2 cells without KRAS or BRAF mutations were highly sensitive. The combination of FOLFOX or FOLFIRI with cetuximab resulted in an additive antitumor effect. Conclusions: CD-DST appears to be useful in predicting the prognosis of patients with stage II/III colorectal cancer and the effect of cetuximab combination chemotherapy.</p>

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