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- Title
ATP assay-guided chemosensitivity testing for gemcitabine with biopsy specimens obtained from unresectable pancreatic cancer using endoscopic ultrasonography-guided fine-needle aspiration.
- Authors
Wakatsuki, Takeru; Irisawa, Atsushi; Terashima, Masanori; Shibukawa, Goro; Takagi, Tadayuki; Imamura, Hidemichi; Takahashi, Yuta; Sato, Ai; Sato, Masaki; Ikeda, Tsunehiko; Suzuki, Rei; Hikichi, Takuto; Obara, Katsutoshi; Ohira, Hiromasa
- Abstract
Objectives: This study evaluates the feasibility of chemosensitivity testing by use of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) samples and determines the optimum cut-off value for gemcitabine. Methods: Thirty-four consecutive patients with unresectable pancreatic cancer were enrolled. Chemosensitivity (treated/control ratio: T/C ratio) was calculated as the quantity of adenosine triphosphate for a tumor treated with gemcitabine as a percentage of that for the control. To identify the cut-off value sufficient to predict 180 days of progression-free survival (PFS), the receiver operating characteristic curve and the corresponding area under the curve (AUC) were calculated. Results: The success of this assay was 88.2% (30/34); therefore, 30 patients were assessable and included in the population of analyzable patients.. The response was 6.7%. Median PFS was 96 days and median overall survival was 241 days, respectively. The cut-off value was determined as 74% (AUC, 0.745; p = 0.053; 95% CI 0.485-1.005). According to this cut-off value, we predicted 180 days PFS with a sensitivity and specificity of 71.4 and 91.3%, respectively. When patients were divided into two groups at T/C ratio 74%, a significant difference was found in PFS (median 77 vs. 205 days, p = 0.0036). Moreover, T/C ratio < 74% and decrease of CA19-9 were significant and independent prognostic factors by multivariate analysis. Conclusion: Chemosensitivity testing by use of EUS-FNA samples in patients with unresectable pancreatic cancer is feasible. This definition emphasizes the possibility of selecting patients for whom favorable results from gemcitabine treatment can be expected.
- Subjects
ADENOSINE triphosphate; PANCREATIC cancer; ENDOSCOPIC ultrasonography; NEEDLE biopsy; CANCER chemotherapy; DISEASE progression; MULTIVARIATE analysis
- Publication
International Journal of Clinical Oncology, 2011, Vol 16, Issue 4, p387
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-011-0197-3