Journal List > J Breast Cancer > v.13(2) > 1036199

This article has been corrected. See "Erratum: Author's Name Correction" in Volume 13 on page 323.
Choi, Jeong, Lee, Hwang, Ahn, Jung, and Lee: Heterogeneous Chemosensitivity of Breast Cancer Determined by Adeonsine Triphosphate Based Chemotherapy Response Assay



Breast cancer is heterogeneous disease and the response to chemotherapeutic agents is also heterogeneous from patient to patient. Chemotherapy response assay is in vitro test that is performed to evaluate the degree of tumor growth inhibition by chemotherapy drugs. In this study, we performed the chemotherapy response assay using adenosine triphosphate (ATP-CRA) in breast cancer patients and assessed the clinical availability.


Sixty five breast cancer patients were enrolled in this study. Cancer cells were evenly divided and treated with commonly used chemotherapeutic drugs in breast cancer (doxorubicin, epirubicin, 5-fluorouracil, paclitaxel, docetaxel, vinorelbine, and gemcitabine). To verify in vitro ATP-CRA indirectly, we analyzed the correlation between cell death rate (CDR) of doxorubicin and epirubicin, and between doxorubicin and paclitaxel. We also analyzed the mean CDR of doxorubicin, epirubicin and paclitaxel by HER2 status.


We could successfully perform the ATP-CRA in 60 patients (95.2%). In all cases, we can get the results within 7 days. The range of CDR was very wide, from 0 to more than 50%, except gemcitabine. Epirubicin showed the highest mean CDR (39.9%) and doxorubicin, paclitaxel in order. According to the chemosensitivity index, paclitaxel is the most frequently first-ranked and doxorubicin, epirubicin in order. Correlation coefficient between the cell death rate of doxorubicin and epirubicin is 0.4210 and 0.1299 between paclitaxel and doxorubicin. In HER2 positive group, mean CDR of paclitaxel, epirubicin and doxorubicin was higher than in HER2 negative group, even though epirubicin and doxorubicin were not statistically significant (p=0.018, p=0.114, p=0.311, respectively).


ATP-CRA showed heterogeneous results in individual patients. ATP-CRA was successful and can be performed within short time period. According to our in vitro study, it showed similar results with in vivo study but for the clinical use, the prospective randomized controlled trial should be preceded.

Figures and Tables

Figure 1
Cytotoxic effect aganist 7 anticancer drugs. A scatter gram shows heterogeneity of the chemosensitivity for anticancer drugs in the indicated number of patients with breast cancer.
Figure 2
Correlation between the cell death rate for doxorubicin, epirubicin and paclitaxel.
Table 1
Characteristics of the patients (n=60)

IDC=invasive ductal carcinoma; ILC=invasive lobular carcinoma; ER=estrogen receptor; PR=progesterone receptor; HER2=human epidermal growth factor receptor 2.

Table 2
Cell death rate at 1X TDC

TDC=treated drug concentration; 5-FU=5-Fluorouracil.

Table 3
Frequency distribution showing heterogeneity of the chemosensitivity index


Table 4
Mean cell death rate of three chemotherapeutic agents by marker status

ER=estrogen receptor; PR=progesterone receptor; HER2=human epidermal growth factor receptor 2.

*Statistically significant (p=0.018).


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Joon Jeong

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