The use of cell lines or animal models has significant disadvantages when dealing with a set of heterogeneous diseases such as epithelial ovarian cancer. This has clinical relevance in that biomarkers developed using cell line or animal models are often not transferable to the clinical setting. In this study, we describe the development of a robust protocol for developing primary cultures of ovarian cancer which will overcome some of these difficulties. Women undergoing surgery for ovarian cancer were recruited and samples of ascites and solid tumour deposits were used to develop primary cultures. Cells were characterised using a panel of immunofluorescent antibodies prior to use in a variety of assays including functional assessment of DNA repair pathways. During the four year study period, viable cultures, confirmed to be epithelial in origin were generated from 156 of 172 (91%) cases recruited. Characterisation was carried out using a panel of antibodies including pancytokeratin, CA125, EpCAM, MOC-31, D2-40 and vimentin. Senescence occurred between the 2nd and 8th passages in all cultures except one in which spontaneous immortalization occurred. Cells could be successfully cultured even after a period of storage at 4°C and cultured cells were capable of being used for a variety of applications including functional assays. Upon functional assessment there was minimal intra-tumour heterogeneity. It is therefore possible to derive viable ovarian cancer cell cultures in the majority of patients undergoing surgery. Cells cultured directly from patient cancers provide an accurate and highly diverse model.
e17519 Background: Extensive-disease small cell lung cancer (ED-SCLC) carries a poor prognosis. The current standard practice of 4-6 cycles of a platinum based chemotherapy (PC) leads to a median survival of only 9-11 months. The role of thoracic radiotherapy (TRT) in ED-SCLC remains controversial. We report patient outcomes with ED-SCLC with respect to whether they received TRT or not. Methods: The practice of two oncologists from 2005-2009 was retrospectively reviewed. Patient age, performance status (PS) at presentation and site of progression were recorded. Progression-free survival (PFS) and overall survival (OS) were calculated with respect to the patient receiving 4-6 cycles of PC or not and then again in this subgroup with respect to whether or not they had TRT at any time after chemotherapy. Survival data was compared using the log-rank test. Results: 141 patients age 42-86 years old (mean 67.4 years) were identified. 58% were PS 0-2. 56 patients (40%) completed 4-6 cycles of PC with a median PFS of 8.4 months compared to 2.4 months in those that did not (p<0.001), median OS was 8.9 and 3.1 months (p<0.001). Of the 45 who had the site of progression recorded - 49% progressed within the thorax. Of 87 patents who received any chemotherapy, 43 received TRT and 44 did not with median PFS of 7.8 and 5.4 months respectively (p= 0.003) and median OS of 8.9 and 5.9 months (p=0.002). In the 56 patients who received 4-6 cycles of PC, median PFS was 9.2 with and 7.7 months without TRT (p=0.02). Median OS was 10.2 months with and 7.7 without TRT (p=0.02). Conclusions: Patients who received TRT at some point in their treatment demonstrated improved median PFS and OS. The role of TRT in ED-SCLC warrants further evaluation. The results of the REST trial are eagerly anticipated.
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