Growth of Carcinoma of the Esophagus and Gastroesophageal Junction in a Human Tumor Cloning Assay

We have received and attempted to culture 23 specimens from 23 patients with squamous cell carcinoma of the esophagus and 15 specimens from 11 patients with adenocarcinoma of the gastroesophageal junction (GEJ). Evaluable growth, defined as ≥20 tumor colonies per control plate, was achieved in 35% of the esophageal specimens and in 40% of the GEJ specimens. The specimens with evaluable growth yielded 20 evaluable drug tests for the esophageal group and 42 evaluable drug tests for the GEJ group. A positive response to the chemotherapeutic agent, defined as ≤50% survival in the drug treated plates relative to the control plates, was seen in 1 (5%) of the evaluable esophageal specimens and in 20 (47%) of the evaluable GEJ specimens. The only agent active in the esophageal group was cis-platinum (1 of 5 tests). Standard active agents in the GEJ group included: 5-fluorouracil (1 of 1 test), vinblastine (4 of 8 tests), vincristine (1 of 1 test), and VP-16 (1 of 1 test). Active investigational agents included: methylglyoxalbisguanylhydrazone (MGBG) (1 of 1 test), auranofin (3 of 3 tests), vinzolidine (4 of 6 tests), carbetimer (2 of 2 tests), and ametantrone (3 of 3 tests). The cloning results are consistent with the clinical observation that carcinoma of the esophagus and GEJ respond differently to chemotherapy.