Short-term cultures of clinical tumor material: potential contributions to oncology research.

The culture of surgical tumor specimens has long been considered as a potential approach to the tailoring of chemotherapy and radiotherapy to the individual patient, and to the development of improved therapy. Recent work highlighting the importance of cell-cell interactions in the growth and survival of cancer tissue, as well the demonstrated importance of drug- or radiation-induced loss of tumor cells (for instance by apoptosis), points to a need to reexamine the question of what information might be derived from such cultures. In this commentary, we consider whether the short-term culture of human tumor tissue as small cellular aggregates, preserving to some extent the three-dimensional organization of tumors in vivo, can be used to obtain information on the behavior of cancer cells before and after therapy. Using [3H]thymidine incorporation as an end-point, we show how the shapes of dose-response curves might be used to estimate two key cytokinetic properties of the cultured cells, proliferation rate, and susceptibility to drug- or radiation-induced cell death. We have illustrated this discussion with our studies of melanoma, ovarian cancer, and lung cancer samples. We consider how application of culture methods may lead not only to the discovery of new antitumor drugs, but also to improved choice of patients' treatment.