尿路悪性腫瘍におけるhuman tumor clonogenic assayを用いた抗癌剤感受性試験の検討

Abstract

1982年12月より尿路悪性腫瘍の手術材料を用いて, human tumor clonogenic assayによる抗癌剤感受性試験を行っている.尿路悪性腫瘍67例(腎盂・尿管移行上皮癌13例, 膀胱移行上皮癌14例, 腎細胞癌33例および睾丸腫瘍4例)に本assayを施行した.そのコロニー形成率は尿路上皮癌では0.01～0.5%, 腎細胞癌0.05～0.3%, および睾丸腫瘍では0.01%であった.抗癌剤感受性判定基準としてVon Hoffらに準じた方法とともに, 一方ではTI値による感受性判定を行った.いずれかの判定法で感受性評価可能例は尿路上皮癌30例中16例, 腎細胞癌33例中13例および睾丸腫瘍4例中1例にみられ, 計67例中30例であった.尿路上皮癌においてVon Hoffらの判定基準ではCDDPに対して27%(4/15), ADMおよびCQに対してはいずれも20%(3/15)が有感受性と判定された.TI値による判定基準ではADMに対して18%(2/11), CDDPに対し17%(2/12)が有感受性と判定された.腎細胞癌については前者の判定基準によれば, VLBに対し36%(4/11), CDDPおよびADMに対してそれぞれ25%(1/4), 20%(2/10)で有感受性と判定された.後者の判定基準ではCDDPに対し50%(1/2), VLBに対し43%(3/7), ADMに対しては17%(1/6)が有感受性と判定された.以上の2つの判定法でまったく一致した結果は14例で得られたが, 残る症例においては今後の臨床応用での結果によりいずれの判定法が有効性が高いか判断さぜるを得ない

Surgical tumor specimens from 67 urological malignancy patients were subjected to a human tumor clonogenic assay (HTCA) developed by Hamberger and Salmon. Appreciable growth of colonies was obtained in 20 of the 33 renal cancers, 20 of the 30 urothelial cancers and 1 of the 4 testicular cancers examined. Using HTCA, a plating efficiency ranging from 0.01 to 0.5% was obtained in these urologic malignancies. However, colonial growth adequate for chemosensitivity was obtained in 30 of these 67 patients. According to Von Hoff's definition, more than a 70% decrease in the plating efficiency after anticancer drug exposure was defined as susceptible. Susceptibility to vinblastine (VBL) was seen in 4 of the 11 patients with renal cancer. Susceptibility to cis-dichlorodiamine platinum (CDDP) was seen in 4 of the 15 patients with urothelial cancer, 1 of the 4 patients with renal cancer, and that to adriamycin (ADM) was seen in 3 of the 15 patients with urothelial cancer, 2 of the 10 patients with renal cancer and 1 patient with testicular cancer. For comparison, the ratio of IC90 to the peak plasma concentration of the drug tested was used as the "in vivo-in vitro therapeutic index (TI)". According to TI, susceptibility to VBL was seen in 3 of the 7 patients with renal cancer, and that to CDDP was seen in 2 of the 12 patients with urothelial cancer, and 1 of the 2 patients with renal cancer. Susceptibility to ADM was seen in 3 of the 15 patients with urothelial cancer, and 1 of the 6 patients with renal cancer.(ABSTRACT TRUNCATED AT 250 WORDS)