PMID- 19609620
OWN - NLM
STAT- MEDLINE
DCOM- 20091215
LR  - 20090925
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 16
IP  - 10
DP  - 2009 Oct
TI  - Survival among patients with platinum resistant, locally advanced non-small cell 
      lung cancer treated with platinum-based systemic therapy.
PG  - 2848-55
LID - 10.1245/s10434-009-0608-0 [doi]
AB  - BACKGROUND: Recent adjuvant chemotherapy trials after resection of stage II and 
      III non-small cell lung cancer (NSCLC) have identified important survival 
      differences among patients with immunohistochemical evidence suggesting platinum 
      resistance. No clinical information exists regarding the impact upon survival of 
      patients treated with platinum agents who exhibit cellular evidence of their 
      tumors' resistance to platinum. We evaluated the utility of the extreme drug 
      resistance (EDR) assay to predict mortality among a consecutive group of stage II 
      through IV NSCLC patients receiving adjuvant or definitive platinum-based 
      chemotherapy after resection or surgical biopsy. METHODS: The Extreme Drug 
      Resistance (EDR) Assay is a clinically validated cellular proliferation assay 
      used to test tumors for chemotherapy drug resistance. Based on response in the 
      EDR assay, tumor specimens from stage II through IV NSCLC patients were 
      segregated into three groups: extreme drug resistant (EDR), intermediate drug 
      resistant (IDR), and low drug resistant (LDR). Patient survival was evaluated 
      after platinum-based chemotherapy. RESULTS: Platinum IDR/EDR was statistically 
      significant in predicting shorter overall survival (29.8 months vs. 15.6 months) 
      among platinum IDR/EDR-resistant patients compared with LDR patients (P = 0.047). 
      Median survival was 16.6 months for patients with IDR/EDR to platinum and any 
      other second agent of doublet therapy compared with patients with LDR to any 
      platinum-based doublet where median survival was not achieved (P = 0.0268). 
      CONCLUSIONS: This is the first study to demonstrate the utility of the EDR assay 
      to predict poor clinical outcome when platinum-based therapy is used to treat 
      patients with biological evidence of tumor resistance to platinum. These data 
      corroborate the finding of recent studies evaluating possible molecular 
      correlates to poor response to specific chemotherapeutic agents.
FAU - d'Amato, Thomas A
AU  - d'Amato TA
AD  - Forum Health-Western Reserve Health System, Youngstown, OH, USA. tadamato@att.net
FAU - Pettiford, Brian L
AU  - Pettiford BL
FAU - Schuchert, Mathew J
AU  - Schuchert MJ
FAU - Parker, Ricardo
AU  - Parker R
FAU - Ricketts, William A
AU  - Ricketts WA
FAU - Luketich, James D
AU  - Luketich JD
FAU - Landreneau, Rodney J
AU  - Landreneau RJ
LA  - eng
PT  - Journal Article
DEP - 20090716
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
RN  - 0 (Organoplatinum Compounds)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Non-Small-Cell Lung/drug therapy/*mortality/secondary
MH  - Cell Proliferation
MH  - *Drug Resistance, Neoplasm
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lung Neoplasms/drug therapy/*mortality/pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Organoplatinum Compounds/*therapeutic use
MH  - Prognosis
MH  - Prospective Studies
MH  - Salvage Therapy
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2009/07/18 09:00
MHDA- 2009/12/16 06:00
CRDT- 2009/07/18 09:00
PHST- 2008/08/03 00:00 [received]
PHST- 2009/06/16 00:00 [accepted]
PHST- 2009/04/15 00:00 [revised]
PHST- 2009/07/18 09:00 [entrez]
PHST- 2009/07/18 09:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - 10.1245/s10434-009-0608-0 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2009 Oct;16(10):2848-55. doi: 10.1245/s10434-009-0608-0. Epub 
      2009 Jul 16.