Diagnostic methods and kits for monitoring response to chemotherapy in ovarian cancer
Provided are methods of determining a response to a chemotherapeutic agent in a subject with ovarian cancer, comprising: determining a RNA integrity value of a sample comprising ovarian cancer cell RNA from the subject after the subject has received one or more doses of the chemotherapeutic agent; wherein a low RNA integrity value and/or RNA degradation of the cancer cell RNA is indicative that the cancer is responding to the chemotherapeutic agent and/or a high RNA integrity value and/or stable RNA integrity of the ovarian cancer cell RNA is indicative that the cancer is resistant to the chemotherapeutic agent.
1. An in vitro method of identifying synergistic combinations of chemotherapeutic agents, comprising:
a. harvesting human ovarian cancer cells, placing the harvested cells in different test wells, and incubating the harvested cells in the different test wells with each chemotherapeutic agent and with a combination of the chemotherapeutic agents for at least 1 hour;
b. collecting floating and adherent ovarian cancer cells for each of the test wells;
c. isolating RNA from each of the collected ovarian cancer cells to provide a RNA sample for each test well, said isolating comprising lysing the collected ovarian cancer cells in a RNA stabilizing composition, preparing a precipitation mixture of the lysed ovarian cancer cells, adding the precipitation mixture to a RNA isolating column and eluting the RNA from the column with a RNAse free liquid;
d. determining a RNA integrity value of each RNA sample, said determining comprising separating the RNA sample using capillary electrophoresis apparatus; producing an electropherogram of the separated RNA sample and quantitating the RNA integrity of the separated RNA sample by assessing the electropherogram, wherein the RNA integrity value is a RNA integrity number (RIN);
e. identifying the chemotherapeutic combination as synergistic when the reduction in RNA integrity is greater than any additive reduction in RNA integrity of the cancer cells treated with each agent of the combination alone or otherwise identifying the combination as non-synergistic; and
f. testing the synergistic combinations in one or more assays selected from a clonogenic assay.
2. The method of claim 1 , wherein the ovarian cancer cells are from an ovarian tumour sample obtained from a subject.
3. The method of claim 1 , wherein the RNA integrity value indicative of synergy is decreased at least by 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80% or at least 90% below an additive reduction.
4. The method of claim 1 , wherein the RNA integrity value is determined by calculating a 28S:18S ribosomal (rRNA) ratio.
5. A method of treating a subject with ovarian cancer comprising:
a. determining synergistic cancer responsiveness to a chemotherapeutic agent combination according to claim 1 ; and
b. altering the cancer treatment to the combination, if the combination tested is synergistic.
6. The method of claim 1 , wherein the combination of chemotherapeutic agents comprises an anthracycline and/or taxane.
7. The method according to claim 1 , wherein the ovarian cancer cells are serous ovarian cancer cell line.
8. The method of claim 1 , wherein the ovarian cancer cells are an A2780 cell line.
9. The method of claim 1 , wherein the RNA integrity value is determined using an microcapillary electrophoresis machine.
10. The method of claim 6 , wherein the taxane is selected from docetaxel, paclitaxel and combinations thereof.
11. The method of claim 6 , wherein the anthracycline is selected from doxorubicin and epirubicin and combinations thereof.
12. The method of claim 1 , wherein the ovarian cancer cells or the isolated RNA sample is sent to a testing site.