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Gynecologic Oncology Research and Practice

, 1:7

First Online: 06 December 2014Received: 21 February 2014Accepted: 22 April 2014DOI: 10.1186-2053-6844-1-7

Cite this article as: Dalton, H.J., Fiorica, J., McClure, C.K. et al. gynaecol oncol res pract 2014 1: 7. doi:10.1186-2053-6844-1-7


BackgroundWhile most gynecologic cancers respond to first-line cytotoxic chemotherapy, treatment of recurrent disease is frequently associated with acquired drug resistance. In order to find an in vitro surrogate of this clinical phenomenon, a tumor chemoresponse assay was studied.

Methods-MaterialsPatients who had tissue submitted for repeated chemoresponse testing were identified through a retrospective search. Sixty-three patients met inclusion criteria chemoresponse testing completed at primary diagnosis and upon recurrence of disease and assays completed ≥90 days apart. The Wilcoxon signed-rank test was used to compare chemoresponse, represented as a response index RI, between primary and recurrent measurements. In a secondary analysis, response was categorized and coded as Responsive = 3, Intermediately Responsive = 2 and Non-Responsive = 1, and the paired t-test was used to compare chemoresponse between primary and recurrent measurement.

ResultsMedian time between primary and recurrent tumor testing was 309 days IQR 208–422. Drugs tested included carboplatin, cisplatin, docetaxel, doxorubicin, gemcitabine, paclitaxel, topotecan, and combination carboplatin-gemcitabine and carboplatin-paclitaxel. There were no differences in chemoresponse between primary and recurrent measurement when chemoresponse was represented by RI scores; although a trend toward increased resistance to paclitaxel upon recurrence was noted. When chemoresponse was analyzed as a continuous variable corresponding to categorized response, a significant shift toward increased resistance to paclitaxel at recurrence, and a marginally significant trend toward increased resistance to carboplatin at recurrence, were observed.

ConclusionsWe observed a trend toward increased chemoresistance at recurrence for paclitaxel, and a marginally significant trend toward increased chemoresistance to carboplatin, but no change in chemoresponsiveness between primary diagnosis and recurrence of disease for other common chemotherapy drugs, including common second-line agents such as doxorubicin, gemcitabine, and topotecan.

KeywordsGynecologic cancer Drug resistance Recurrent ovarian Chemotherapy Cross-resistance  Download fulltext PDF

Autor: Heather J Dalton - James Fiorica - Candace K McClure - Rodney P Rocconi - Fernando O Recio - John L Levocchio - Matthew


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