Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.4036
Peer-review started: August 13, 2019
First decision: September 23, 2019
Revised: November 8, 2019
Accepted: November 14, 2019
Article in press: November 14, 2019
Published online: December 6, 2019
Processing time: 114 Days and 22 Hours
We report the first case, to the best of our knowledge, of massive ascites due to recurrent malignant pleural mesothelioma that was controlled using KM-cell-free and concentrated ascites reinfusion therapy (KM-CART). The tumor cells derived via KM-CART were utilized secondarily in an in vitro cell growth assay using the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) to investigate anticancer drug susceptibility.
A 56-year-old man presented with recurrent malignant mesothelioma with massive ascites; more than 4000 mL of ascitic fluid was removed, filtered, and concentrated using KM-CART, and the cell-free ascitic fluid was reinfused into the patient to improve quality of life. Cancer cells isolated secondarily in an in vitro proliferation assay using CD-DST exhibited low sensitivity to pemetrexed and high sensitivity to gemcitabine. Treatment with gemcitabine maintained stable disease for 4 mo.
The combination of KM-CART and CD-DST may be a promising treatment option for malignant ascites associated with malignant mesothelioma.
Core tip: Massive ascites due to recurrent malignant mesothelioma was controlled with innovative cell-free and concentrated ascites reinfusion therapy, and the derived tumor cells were utilized secondarily in an in vitro cell growth assay that contributed to the personalized chemotherapy for the patient.