Gan to kagaku ryoho. Cancer & chemotherapy
-
Gan To Kagaku Ryoho · May 2009
[The progress of second-line chemotherapy and molecular targeting agents in gastric cancer].
According to the results of Japanese phase III trials recently reported such as JCOG 9912 and SPIRITS, there was a remarkable improvement in median survival time compared to the previous phase III study(JCOG 9205). Many newer agents were used, such as taxane and irinotecan, which were absent during JCOG 9205. Using these agents as a second- line treatment may lead to improved survival. ⋯ On the other hand, molecular targeting agents that have shown activity in other tumor types such as trastuzumab, bevacizumab, cetuximab, and lapatinib are under investigation in global randomized control trials. In these trials, patients from Japan and Korea account for more than half of the enrollees. The number of international studies is increasing, and the role of east Asian countries will be more important in this field.
-
Gan To Kagaku Ryoho · Apr 2009
[Examination about the influence for daily life that nail and skin disorders induced by docetaxel in patients with breast cancer].
Docetaxel is one of the most important chemotherapeutic agents for the breast cancer patients. However, it has also experienced as toxicities causing nail diformation and skin trouble, and is considered as adverse elements other than edema and neurotoxicity. It is expected to have tremendous influence on women's daily life-decrease in quality of life. ⋯ Skin impediments have found most during the second and the third courses; the contents include discomfort towards their beauty and housework. Influence to their daily life that the patients feel do not necessarily match the contents that doctors have recognized. In conclusion, this investigation evidenced that the troubles on quality of life such as nail and skin troubles, should be paid more attention, as well as major side effects such as edema, neutropenia, and neurotoxicity.
-
Gan To Kagaku Ryoho · Apr 2009
[Circumventing resistance to imatinib therapy in chronic myeloid leukemia].
In the emergence of resistance to imatinib, ABL-kinase inhibitor has become a significant problem despite the remarkable clinical results achieved with this drug in the treatment of chronic myeloid leukemia. The most common cause of imatinib resistance is the selection of leukemic clones with point mutation in the ABL-kinase domain. Persistent disease is another therapeutic challenge and may in part, be due to the inability of imatinib to eradicate primitive stem cell progenitors. A multitude of novel agents have been developed and shown efficacy in overcoming imatinib resistance.
-
Rituximab is commonly incorporated into CD20-positive B-cell lymphoma therapy to improve response and prognosis. With increasing use, resistance to rituximab is a continuing concern, but CD20 mutation as a cause of resistance has not previously been reported. Freshly collected lymphoma cells from 50 patients with previously untreated or relapsed/resistant non-Hodgkin's B-cell lymphomas(diffuse large B cell, n=22; follicular, n=7; mucosa associated lymphoid tissue, n=16; chronic lymphocytic leukemia, n=2; small lymphocytic lymphoma, n=1; lymphoplasmacytic, n =1; mantle cell lymphoma, n=1)were assessed for CD20 expression by flow cytometry, and CD20 gene sequencing was performed on extracted DNA. ⋯ It is possible that C-terminal deletion mutations of CD20 may be related to relapse/resistance after rituximab therapy. These mutations should be examined in patients showing progression of disease after partial remission. Other mechanisms are also discussed.