Chemosensitivity testing predicts survival in ovarian cancer

The aim of this study was to assess the use of the MTT assay for chemosensi tity testing to identify drug resistance and predict survival in patients w ith advanced ovarian cancer, Samples of ascitic fluid and/or solid biopsies were taken from 120 patients with FIGO stage III or IV ovarian adenocarcin oma at presentation. Cells were exposed for 48 hours to four concentrations of clinically relevant drugs including platinums, anthracyclines and alkyl ating agents. Cell survival was measured using the 3-4,5-dimethyl-2, 5-diph enyl tetrazolium bromide (MTT) assay allowing patients to be grouped as "se nsitive" or "resistant" in vitro. Clinical data including age, residual dis ease, histological grade, treatment, response after initial treatment and o verall survival were collected. There was a highly significant (p <0.0001) correlation of in vitro sensitivity with in vivo response in the patients w ho completed their therapy, with an 83% positive predictive accuracy for re sistance. This translated in the longer term to an increased survival for t he patients found to be sensitive in vitro to their therapy with a 5-year s urvival rate of 24% compared to 12% for the resistant group (p=0.033). Thes e results suggest that MTT chemonsensitivity testing can predict response i n ovarian cancer leading to the prospect of increased survival in this deva stating disease by customising therapy to individual patients.