Comparative Analysis of ATP-based Tumor Chemosensitivity Assay-Directed Chemotherapy Versus Physician-Decided Chemotherapy in Platinum-Resistant Recurrent Ovarian Cancer

Objective The aim of the study was to evaluate the role of ATP-based tumor chemosensitivity assay (ATP-TCA) in patients with platinum-resistant recurrent ovarian cancer (PRROC). Methods A total of 43 patients with PRROC who underwent chemotherapy based on the results of ATP-TCA in the Cancer Hospital, Chinese Academy of Medical Sciences were included in the present study. As controls, we selected another 43 patients with PRROC who were treated at the physician's discretion within the same time period and had the same clinical characteristics as the patients in the ATP-TCA group. Log-rank test and Cox proportional hazards model were adopted for analysis. Results A total of 86 patients were retrospectively analyzed in the present study. Patients were routinely monitored to evaluate the rate of progression-free survival (PFS). The median follow-up time was 13 months. The PFS for the ATP-TCA and control groups was 5 and 3 months, respectively ( P = 0.027). Multivariate analysis showed that the type of treatment was an independent prognostic factor for PFS ( P = 0.040; HR: 0.623; 95% CI: 0.313-0.973). Subgroup analysis showed that among patients with a treatment-free interval (TFI) of ≥ 3 months ( n = 50), those in the ATP-TCA group had longer PFS than those in the control group (7 vs 4 months, P = 0.010). Meanwhile, the median PFS of patients who underwent ≤ 2 prior chemotherapy regimens (PCR, n = 52) in the ATP-TCA and control groups was 6 months and 4 months, respectively ( P = 0.025). Conclusion ATP-TCA-directed chemotherapy might improve the PFS in PRROC. In particular, the survival benefit from ATP-TCA is higher in patients with a TFI of ≥ 3 months or treated with ≤ 2 PCR.