Correlation of Early Systemic Recurrence with In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay in Stage II and III Breast Cancer Patients Treated with Doxorubicin-Based Chemotherapy

Sung Gwe Ahn; Joon Jeong; Suk Kyung Choi; Seung Hyun Hwang; Seung Ah Lee; Woo Hee Jung; Hy-De Lee

doi:10.4048/jbc.2011.14.S.S50

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Ahn, Jeong, Choi, Hwang, Lee, Jung, and Lee: Correlation of Early Systemic Recurrence with In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay in Stage II and III Breast Cancer Patients Treated with Doxorubicin-Based Chemotherapy

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2011; 14(Suppl 1): S50-S56.

Published online: 28 February 2011

DOI: https://doi.org/10.4048/jbc.2011.14.S.S50

Correlation of Early Systemic Recurrence with In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay in Stage II and III Breast Cancer Patients Treated with Doxorubicin-Based Chemotherapy

Sung Gwe Ahn, Joon Jeong

, Suk Kyung Choi, Seung Hyun Hwang, Seung Ah Lee, Woo Hee Jung¹, Hy-De Lee

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

¹Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

Correspondence: hdlee@yuhs.ac

Received 10 December 2010 Accepted 9 February 2011

Abstract

Purpose

An in vitro adenosine triphosphate-based chemotherapy response assay (ATP-CRA) was designed to require only a limited number of cells and shorten test turnaround time with a high success rate. This study investigated the correlation between in vitro doxorubicin sensitivity of tumor cells and early systemic recurrence, defined as recurrence within 2 years after surgery.

Methods

From January 2004 to March 2007, the ATP-CRA for doxorubicin was tested in 128 patients among breast cancer patients treated at Gangnam Severance Hospital, Seoul, Korea. The American Joint Committee on Cancer stages for all patients were II and III. All patients received doxorubicin-based chemotherapy. Selected patients were divided into a chemosensitive group and a non-chemosensitive group, according to a 40% cell death rate as a cut-off value. We analyzed the relationship between chemosensitivity and early systemic recurrence in patients with breast cancer.

Results

The mean age of the patients investigated was 44.6-years-old, the mean follow-up period was 39.9 months, and recurrence free survival was 38.6 months. Thirteen recurrences were observed during follow-up. Among 13 patients with a recurrence, eight had a recurrence within 2 years (early recurrence). All of the early recurring patients belonged to the non-sensitive group. Doxorubicin sensitivity results measured by ATP-CRA were related with early recurrence free survival in patients with breast cancer (p=0.030). The mean cell death rate derived from the ATP-CRA for the early recurrence group tended to be lower than that of the non-early recurrence group, but the difference was not statistically significant (p=0.05).

Conclusion

Doxorubicin sensitivity measured by ATP-CRA was well correlated with in vivo drug responsibility to predict early recurrence against doxorubicin-based adjuvant chemotherapy in patients with breast cancer.

Keywords: Neoplasms, Chemosensitivity, Doxorubicin resistance, Early recurrence

Figures and Tables

Figure 1

Kaplan-Meier survival estimation graph according to doxorubicin sensitivity measured by ATP-CRA (A, Recurrence free survival; B, Early recurrence free survival).

Figure 2

Comparison mean cell death rate of early recurrence cases with that of early recurrence free cases.

Table 1

Clinicopathologic characteristics of patients

AC=adriamycin+cyclophosphamide; T=paclitaxel; CAF=cyclophosphamide+adriamycin+5-fluorouracil; AD=adriamycin+docetaxel; AJCC=American Joint Committee on Cancer Committee; HG=histologic grade; ER=estrogen receptor; PR= progesterone receptor.

Table 2

Relationship between early recurrence and clinicopathologic charactertistics

AC=adriamycin+cyclophosphamide; T=paclitaxel; CAF=cyclophosphamide+adriamycin+5-fluorouracil; AD=adriamycin+docetaxel; HG=histologic grade; ER=estrogen receptor.

Table 3

Early recurrence free survival using Kaplan-Meier method according to doxorubicin sensitivity and clinicopathologic characteristics

HG=histologic grade, ER=estrogen receptor; CRA=chemotherapy response assay.

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ORCID iDs: Joon Jeong
https://orcid.org/http://orcid.org/0000-0003-0397-0005
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