American Society of Clinical Oncology Clinical Practice Guideline Update on the Use of Chemotherapy Sensitivity and Resistance Assays

Published in Journal of Clinical Oncology, Vol 29, Issue 24 (August), 2011: 3328-3330
Harold J. Burstein, Pamela B. Mangu, Mark R. Somerfield, Deborah Schrag, David Samson, Lawrence Holt, Debra Zelman, and Jaffer A. Ajani


To update the American Society of Clinical Oncology Technology Assessment: Chemotherapy Sensitivity and Resistance Assays (CSRA) published in 2004.


An Update Working Group reviewed data published between December 1, 2003 and May 31, 2010. MEDLINE and the Cochrane Library were searched. The literature search yielded 11,313 new articles. The limits for “human and English” were used and then standard ASCO search strings for RCTs, meta-analyses, guidelines, and reviews were added, yielding 1,298 articles for abstract review. Of these, only 21 met predefined inclusion criteria and underwent full text review and 5 reports of RCTs were included for data extraction.


Review of the literature does not identify any CSRAs for which the evidence base is sufficient to support use in oncology practice.


The use of chemotherapy sensitivity and resistance assays to select chemotherapeutic agents for individual patients is not recommended outside of the clinical trial setting. Oncologists should make chemotherapy treatment recommendations on the basis of published reports of clinical trials and a patient’s health status and treatment preferences. Because the in-vitro analytic strategy has potential importance, participation in clinical trials evaluating these technologies remains a priority.


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The clinical practice guidelines and other guidance published herein are provided by the American Society of Clinical Oncology, Inc. ("ASCO") to assist practitioners in clinical decision making. The information therein should not be relied upon as being complete or accurate, nor should it be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. With the rapid development of scientific knowledge, new evidence may emerge between the time information is developed and when it is published or read. The information is not continually updated and may not reflect the most recent evidence. The information addresses only the topics specifically identified therein and is not applicable to other interventions, diseases, or stages of diseases. This information does not mandate any particular course of medical care. Further, the information is not intended to substitute for the independent professional judgment of the treating physician, as the information does not account for individual variation among patients. Recommendations reflect high, moderate or low confidence that the recommendation reflects the net effect of a given course of action. The use of words like "must," "must not," "should," and "should not" indicate that a course of action is recommended or not recommended for either most or many patients, but there is latitude for the treating physician to select other courses of action in individual cases. In all cases, the selected course of action should be considered by the treating physician in the context of treating the individual patient. Use of the information is voluntary. ASCO provides this information on an "as is" basis, and makes no warranty, express or implied, regarding the information. ASCO specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. ASCO assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions.