Tumor heterogeneity and in vitro chemosensitivity testing in ovarian cancer

Am J Obstet Gynecol. 1997 Apr;176(4):759-66; discussion 766-8. doi: 10.1016/s0002-9378(97)70599-4.


Objective: Our purpose was to study the heterogeneity of drug response in fresh human ovarian tumors to chemotherapeutic agents in an in vitro chemosensitivity assay.

Study design: This assay evaluates total tumor cell kill by measuring the intracellular adenosine triphosphate levels of untreated controls and drug-exposed cells at various doses after culture for 6 days. The surviving fraction is calculated by dividing the treated values with the control values. One hundred tumors were tested against four single drugs (cisplatin, the active metabolite of cytoxan, 4-hydroxyperoxy-cyclophosphamide, Taxol, and carboplatin) and two drug combinations (cisplatin plus 4-hydroxyperoxy-cyclophosphamide; cisplatin plus Taxol).

Results: There is great variation in the degree of cell death for single drugs and drug combinations among the 100 tumors tested.

Conclusion: More effective clinical response to chemotherapy may be achieved in patients with ovarian cancer by selecting the most active drugs for chemotherapy, on the basis of in vitro chemosensitivity test results for individual patients.

MeSH terms

  • Adenosine Triphosphate / metabolism*
  • Antineoplastic Agents / pharmacology*
  • Antineoplastic Agents / therapeutic use
  • Carboplatin / pharmacology
  • Carboplatin / therapeutic use
  • Cell Survival / drug effects
  • Cisplatin / pharmacology
  • Cisplatin / therapeutic use
  • Cyclophosphamide / analogs & derivatives
  • Cyclophosphamide / pharmacology
  • Cyclophosphamide / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Screening Assays, Antitumor / methods*
  • Drug Therapy, Combination
  • Female
  • Humans
  • In Vitro Techniques
  • Ovarian Neoplasms / chemistry
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Paclitaxel / pharmacology
  • Paclitaxel / therapeutic use
  • Tumor Cells, Cultured / drug effects


  • 4-hydroxyperoxycyclophosphamide
  • Antineoplastic Agents
  • Adenosine Triphosphate
  • Cyclophosphamide
  • Carboplatin
  • Paclitaxel
  • Cisplatin