Applicability of Histoculture Drug Response Assays in Colorectal Cancer Chemotherapy

Yong Sik Yoon, Chan Wook Kim, Seon Ae Roh, Dong Hyung Cho, Gyu Pyo Kim, Yong Sang Hong, Tae Won Kim, Moon Bo Kim, Jin Cheon Kim

Aim: The present study, using the histoculture drug response assay (HDRA) compared chemosensitivity with the clinical response of a treatment regime in patients with advanced colorectal cancer (CRC). 

Patients and Methods: A total of 324 patients with primary CRC were prospectively enrolled. HDRAs were performed using seven combinations of anticancer drugs, including 5-fluorouracil with leucovorin (FL), FL with oxaliplatin (FOLFOX), irinotecan (FOLFIRI), and their combinations with bevacizumab and cetuximab.

Results: Among 324 HDRA results, tumor inhibition rates of regimes using FOLFOX (34.2-39.2%) were higher than those using FOLFIRI (24.2-32.7%, p<0.001). Out of 86 evaluated chemotherapeutic regimes, the correlation rate of HDRA to the clinical effect of chemotherapy was calculated to be 66.3% (57/86), with a 72.7% (40/55) sensitivity and a 54.7% (17/31) specificity. 

Conclusion: HDRA might be a feasible and useful technique for predicting therapy efficacy and selecting the appropriate anticancer regime for individual patients, notwithstanding its low accuracy.

Key Words: Colorectal adenocarcinomas, chemotherapy, histoculture drug response assay (HDRA), molecular targeted therapy, treatment outcome.