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Human Tumor Clonogenic Assay(HTCA)¸¦ ÀÌ¿ëÇÑ ¾Ç¼º Á¾¾çÀÇ ¾à¹° °¨¼ö¼º°ú ÀÓ»ó ¹ÝÀÀ°£ÀÇ ºñ±³ Clinical Comparison with Drug Sensitivities by the Human Tumor Clonogenic Assay

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±è»óÈñ ( Kim Sang-Hee ) 
The Christ Hospital University of Cincinnati Gamble Medical Research Institute College of Medicine

Abstract

ÀúÀÚ´Â soid tumorȯÀÚ¿¡¼­ äÃëÇÑ ¾Ï¼¼Æ÷¸¦ HTCAÀ» ÀÌ¿ëÇÏ¿© ½ÇÇè»ø³»¿¡¼­ ȯÀÚÀÇ ¾Ï¼¼Æ÷ÀÇ Ç×¾ÏÁ¦¿¡ ´ëÇÑ ¾à¹° °¨¼ö¼ºÀ» ÃøÁ¤ÇÏ°í, À̸¦ ¾ÏȯÀÚÀÇÀÓ»ó ¹ÝÀÀÀÇ°á°ú¿Í ºñ±³ÇÏ¿© HTCAÀ» ÀÌ¿ëÇÑ ¾àµÑ °¨¼ö¼ºÀÇÀÓ»ó ¹ÝÀÀ ¿¹Ãøµµ¸¦ Á¶»çÇÏ¿´´Ù.
HTCAÀ» ½ÃÇàÇÑ soid tumor´Â À¯¹æ¾Ï 79¿¹, ´ëÀå¾Ï 70¿¹ ¿ù¹ßºÎÀ§¸¦ ¾Ë¼ö ¾ø´Â ȯÀÚ°¡ 35¿¹·Î ÃÑ 182¿¹¿´À¸¸ç, ÀÌÁß 85%ÀÇ¿¹¿¡¼­ Ŭ·Î¿îÀÇ ¼ºÀåÀ» °üÂûÇÒ ¼ö ÀÖ¾ú´Ù. °´°üÀûÀ¸·Î Á¾¾çÀÇÅ©±â¸¦ ÃøÁ¤ÇÒ ¼ö ÀÖÀ¸¸ç 3ȸ ÀÌ»ó Ç×¾ÏÁ¦¸¦ Åõ¿©ÇÏ¿© ÀÓ»ó ¹ÝÀÀÀ» °üÂû¼ö ÀÖ¾ú´ø ȯÀÚ´Â 57¸í(À¯¹æ¾Ï 25¸í, ´ëÀå¾Ï 23¸í, ¿ø¹ß ºÎÀ§¸¦ ¾Ë¼ö ¾ø´Â ȯÀÚ°¡ 9¸í)À̾ú´Ù.ÀÌ 57¸íÀÇ È¯ÀÚ¸¦ ´ë»óÀ¸·Î ½ÇÇè½Ç³»¿¡¼­ÀÇ HTCAÀÇ ¾à¹° °¨¼ö¼ºÀÇÀÓ»ó ¹ÝÀÀ ¿¹Ãøµµ¸¦ ºÐ¼®ÇÑ °á°ú ,ÀÓ»óÀû·Î ÆÇ´ÜÇÑ °¨¼ö¼º(sensitivity)ÀÇ °æ¿ì 93%(95% conficence limits:77%~99%)¿¡¼­, ³»¼º(resistance)ÀÇ °æ¿ì 97%*78%~100%)¿¡¼­ ¿¹ÃøÇÒ ¼ö ÀÖ¾ú´Ù. µû¶ó¼­ HTCAÀÇ ¹Î°¨µµ(sensitivity)´Â 96%(95% confiednce limits:81%~100%), ƯÀ̵µ´Â 93%(78%~99%)·Î¼­ ½ÇÇè½Ç³»¿¡¼­ÀÇ ¾à¹° °¨¼ö¼ºÀÇÁ¤µµ¾Æ ÀÓ»ó ¹ÝÀÀ°£¿¡´Â Åë°èÀûÀ¸·Î À¯ÀÇÇÑ »ó°ü °ü°è°¡ ÀÖ¾ú´Ù.(p<0.0005)
We tested the ability of the in vitro humman tumor clonogenic assay (HTCA) to predict clinical response for patients with solid tumors. Patients had objectively measurable disease and received three or more courses of single or combination chemotherapy directed by HTCA results.
The correlation between clinical responses and in vitro sensitivity was evaluated in 57 patients.
Tumor types included breast cancer (25 cases), colon cancer (23 cases) and primary unknown adenocarcinoma (9 cases).
In these 57 comparisons, overall predictive accuracy of HTCA for clinical sensitivity was 93%, predictive accuracy for resistance was 97%.
Our results suggest that in vitro selection of effective drugs may avoid unnecessary toxicity while assuring therapeutic effects in palliative and adjuvant chemotherapy for the treatment of colon, breast and primary unknown adenocarcinoma.

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