Long term culture of human tumor cells from malignant effusions as a tool for individualizing chemotherapy

In order to determine whether long term culture of cells obtained from effusions affords a practical tool for individualizing drug therapy tumor cells were obtained by paracentesis from patient PD with advanced ovarian carcinoma and cultured in medium 199 containing 20% FCS. Nonmalignant cells did not replicate in this system. In primary, and all succeeding generations (> 6 mos.) differentiated organization and function obtain. Two cell types were found; spindle shaped cells devoid of contact inhibition which orient themselves circumferentially around small nests of flat polygonal cells. The latter are characterized by secretion of lipid. In the presence of both cell types 148 pg/ml of β 17 estradiol was found in the medium as compared to 60 pg/ml for equivalent cultures of mouse mammary tumor cells and 30 pg/ml for cell free medium. Assay for other steroids and HCG was negative. Since growth measurement is precise, quantitative drug effects are readily determined. Cell division was blocked by 1 μg/ml adriamycin, but not with hexamethylmelamine, 5 FU, or macromomycin. The patient had received previous courses of HMM and 5 FU so that resistance to these agents may be intrinsic or drug induced. The report demonstrates the practicality of using cell culture from effusions. Recent evidence (Holmes, H.L. and Little, J.M., Lancet, Oct. 26, '74, 985) indicates good correlation between in vitro and in vivo response.