@entity320 has a poor prognosis and chemotherapy provides little benefit for most @entity1 . This may be related to heterogeneity of chemosensitivity as well as frequent constitutive resistance to individual cytotoxic drugs. We have therefore examined the heterogeneity of chemosensitivity in metastatic @entity320 specimens using an ex vivo @entity855 -based chemosensitivity assay ( @entity855 - @entity2974 ). @entity320 (n=55) in skin or lymph node were tested using the @entity855 - @entity2974 , performed in three separate laboratories. Analysis of the data collected (based on an arbitrary sensitivity index < 300) shows considerable heterogeneity of chemosensitivity. The most active single cytotoxic agents in the assay were identified as @entity900 , @entity21193 , @entity1311 , @entity5713 , @entity136 and @entity2664 . There was also a limited direct inhibition of @entity320 cell growth by @entity4020 , although this agent is known to have a number of indirect biological antitumor effects. Exposure of @entity5 cells to combinations of drugs at the concentrations tested as single agents showed the most active combinations to be @entity21193 + @entity136 , @entity900 + @entity1311 and @entity5713 + @entity1311 . There was considerable heterogeneity of chemosensitivity: some @entity5 responded well to one agent or combination, while others showed no response to this and instead responded to one of the alternatives tested. Occasional highly resistant @entity5 showed no response to any of the single agents or combinations tested. The degree of heterogeneity observed suggests that the @entity855 - @entity2974 could be used to select @entity1 who might benefit from specific chemotherapeutic agents alone or in combination. This provides the rationale for future randomized controlled trials of @entity855 - @entity2974 -directed chemotherapy versus physician's choice to determine whether assay-directed chemotherapy can improve @entity1 response and survival.

Heterogeneity of chemosensitivity of metastatic XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity2974 :: ('CHEBI:30956', 'Chemical') :: ['TCA'] @entity21193 :: ('MESH:C018404', 'Chemical') :: ['treosulfan'] @entity1311 :: ('MESH:D017239', 'Chemical') :: ['paclitaxel'] @entity2664 :: ('MESH:D008942', 'Chemical') :: ['mitoxantrone'] @entity5713 :: ('MESH:D014747', 'Chemical') :: ['vinblastine'] @entity4020 :: ('3440', 'Gene') :: ['interferon-alpha2b'] @entity136 :: ('MESH:C056507', 'Chemical') :: ['gemcitabine'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma', 'cutaneous melanoma', 'Melanoma deposits', 'Advanced melanoma'] @entity855 :: ('MESH:D000255', 'Chemical') :: ['ATP']
@entity320 :: (MESH:D008545,Disease) :: ['cutaneous melanoma']
