2021, Number 4
An Med Asoc Med Hosp ABC 2021; 66 (4)
In vitro chemotherapy sensitivity as a potential personalized medicine tool in cancer patients with malignant ascites. An ABC Medical Center Iniciative
Noguez RA, Shveid GD, Villegas ODA, Villalobos PA, Serrano OJA, Olivares BGM, Lázaro LJM, Regalado PGO, Camacho LCP, García LEA, Campos ALD, Murrieta GH, Zentella DA, Gerson CR
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ABSTRACTIntroduction: In patients with metastatic cancer, it is imperative to develop tools for choosing chemotherapy. Chemotherapy sensitivity studies take months, doing it from ascites fluid considerably reduces the needed time. Objective: To evaluate the chemotherapy sensitivity in primary cultures of malignant cells obtained from ascites in order to generate a personalized medicine tool. Material and methods: Clinical trial in patients with metastatic cancer and malignant ascites at the ABC Medical Center. Cell cultures were obtained from each patient and they were exposed to different chemotherapy's, according to the cell death percentage we evaluated the sensitivity. The concordance between progression to chemotherapy and its resistance in vitro was reported as: total, partial or null. Results: 24 patients were included. Most women 13 (54.1%), the mean age was 61 ± 16.1 years, 75% had ECOG 1-2, the lines treatment median was 2 (IQR 1-4). The primary tumors were pancreas 7 (29.1%), breast 6 (25%), colorectal 5 (20.8%), hepatocellular 3 (12.5%), cholangiocarcinoma 2 (8.3%), and peritoneum 1(4.1%). Cell culture was established in 20 samples (80%). Partial or total concordance was found in 11 patients (55%), according to primary tumor was 100% in peritoneum, 83% in pancreas, 60% in colorectal, 50% in cholangiocarcinoma, 25% in breast and 0% in hepatocellular. Conclusions: Culturing neoplastic cells from ascites and exposing them to chemotherapy is feasible and can be performed in two weeks. The concordance between in vitro chemotherapy resistance and clinical progression was notable in peritoneal, pancreatic, and colorectal cancer.