Future Medicine - Full Text Cancer pharmacogenomics: do cancer cell lines have the right stuff?

Note: cell 'lines' (test tube) vs  patient tumors

"....But with all the effort and money being put into pharmacogenomics research using cancer cell lines, it is appropriate to ask: how faithfully do cancer cell lines represent the tumors that they are being used to model?"

"Next, do cancer cell lines behave similarly to the tumors they are intended to model to be useful for pharmacogenomics research? First, cancer cell lines are more appropriate for assessing the response to cytotoxic anticancer drugs, rather than the response to newer biologic agents which exert their anti-tumor effects via mechanisms other than eliciting cell death. Second, an important consideration to keep in mind when using cancer cell lines for pharmacogenomics research is that cell lines are generally more sensitive to cytotoxic agents than solid tumors.

"Another important question is: how well does testing in cancer cell lines predict responses in clinical trials with real world patients? When assessing whether there is a correlation between drug activity in Phase II clinical trials and preclinical activity in cancer cell line models, one study found that preclinical activity did not correlate with Phase II response, with the exception of non-small-cell lung cancer [5].

However, ..........It is becoming more and more apparent that the process of culturing cells in vitro alters the genetic make-up of the cancer cell lines."

Putting research into context—revisited : The Lancet - Editorial

Note: this article is free to view; requires registration

"In July, 2005, Lancet editors wrote that “we will require authors of clinical trials submitted to The Lancet to include a clear summary of previous research findings, and to explain how their trial's findings affect this summary.
They called for the relation between existing and new evidence to be referenced to a published systematic review or meta-analysis. The CONSORT statement2 first required in 1996 that findings should be interpreted to take into account the totality of the evidence.
Michael Clarke and colleagues have been monitoring since then how the five high-impact journals (Annals of Internal Medicine, BMJ, JAMA, The Lancet, and The New England Journal of Medicine) have been doing. They report in The Lancet today their latest results for May, 2009.
Their findings are discouraging: only one of 24 reports that were not first trials placed the results in the context of an updated systematic review in the Discussion.
They conclude that there is no evidence of progress since 1997, and that editors and authors are not informing sufficiently those who have to make decisions about health care."
Clearly, clinicians and others in health care need to know what the results of research mean for patients.
Authors and editors can help them by doing exactly what CONSORT4 and Clarke and colleagues call for. 
Authors need to spell out what their study adds to other work and what that means for clinical practice...."cont'd

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