Choice of adjuvant chemotherapy based on a histocultural drug response assay (HDRA) proved useful in improving survival in patients with non–small-cell lung cancer (NSCLS) who have undergone surgical resection, according to a new study in the September issue of Journal of Thoracic Oncology.
The HDRA examined patients’ chemosensivity to cisplatin, carboplatin, paclitaxel, docetaxel, gemcitabine, and irinotecan. Of 65 patients with stage II or higher NSCLC, 31 were classified as prediction-sensitive (those whose tumors were sensitive to at least two of the drugs) and 34 were classified as prediction-nonsensitve (those whose tumors to one or none of the drugs). Prediction-sensitive patients were treated with two HDRA-positive drugs per session; prediction-nonsenstive patients were treated with one HDRA-positive and one HDRA-negative drug or two HDRA-negative drugs per session.
Overall 5-year survival rates were 82.4% and 40.1% (P = .03) for the prediction-sensitve and prediction-nonsensitve patients, respectively. Five-year disease-free survival rates were 56.6% and 30.1% (P = .05), respectively. Multivariate analysis showed that choice of chemotherapy based on the HDRA was significant prognostic factor (P = .03).