Combination of histoculture drug response assay and qPCR as an effective method to screen biomarkers for personalized chemotherapy in esophageal cancer

Personalized chemotherapy with the use of biomarkers helps to maximize clinical efficiency. Therefore, the present study aimed to identify a potential method for identifying biomarkers in esophageal cancer. A total of 49 freshly resected tumor tissues and 72 paraffin-embedded specimens from patients with esophageal cancer were obtained. mRNA expression levels of ERCC1, BRCA1, TUBB3, FBW7, RRM1, MDM2, TS and TOP1 were measured quantitative reverse transcription polymerase chain reaction (RT-qPCR). In vitro chemosensitivity to cisplatin, docetaxel, gemcitabine, etoposide, fluorouracil and irinotecan were tested using histoculture drug response assay (HDRA). BRCA1 mRNA levels were positively correlated with resistance to cisplatin (P= 0.027) and sensitivity to docetaxel (P= 0.002). TS mRNA levels were inversely correlated with fluorouracil sensitivity (P= 0.044), and TOP1 mRNA expression was positively correlated with irinotecan sensitivity (P= 0.008). In addition, high BRCA1 mRNA levels correlated with decreased median overall survival (mOS; P< 0.001) and response rate (RR; P= 0.002) in cisplatin-fluorouracil chemotherapy group and also correlated with increased mOS (P< 0.001) and RR (P= 0.023) in docetaxel-fluorouracil chemotherapy group. Overall, these results suggested that HDRA combined with RT-qPCR may serve as an effective method for screening biomarkers in personalized chemotherapy for esophageal cancer.