The usefulness of the chick embryo assay as an
in vivo chemosensitivity test was studied in the prediction of the response to combination chemotherapy regimens in clinical use for lung cancer in Japan, such as cisplatin+vindesine (PV therapy), cisplatin+adriamycin+mitomycin C (PAM therapy), and mitomycin C+vindesine+cisplatin (MVP therapy). One hundred and seventeen surgical specimens of advanced lung cancer were examined by this method. All the tumor specimens tested could be grafted on the chorioallantoic membranes of chick embryos, so the evaluation rates was 100%. In this system, the efficacy rates of PV, PAM, and MVP therapy were 16.9, 13.8, and 19.0%, respectively. The efficacy of therapy was in the following order; epidermoid carcinoma>small cell carcinoma>adenocarcinoma>large cell carcinoma>adenosquamous carcinoma. Interestingly, the effect of MVP therapy on epidermoid carcinoma was significantly high.
Twenty-six patients received the same chemotherapy regimens as those tested in the chick embryo assay, and 24 of them could be evaluated for clinical response. In 4 patients, the assay correctly predicted a clinical partial response (true positive). There were no false positive results for this assay, as well as 5 false negative results and 15 true negative results. The overall predictive accuracy was 79.2%. Thus, the chick embryo assay was a good predictor of the clinical outcome. This
in vivo chemosensitivity assay for lung cancer is also advantageous because of its convenience, rapidity, and low cost.
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