Gan to kagaku ryoho. Cancer & chemotherapy
-
Gan To Kagaku Ryoho · Oct 2004
Case Reports[Two cases of postoperative recurrence of gastric GIST treated by imatinib].
We report two cases of postoperative recurrence of gastrointestinal stromal tumor (GIST) treated by the tyrosine kinase inhibitor imatinib mesylate (IM), and discuss some important items. Case 1: This 63-year-old Japanese man received a partial gastrectomy for leiomyosarcoma in 1993. Partial hepatectomy and proximal gastrectomy were performed for liver metastasis and local recurrence in 2001. ⋯ IM is the treatment of choice for unresectable recurrence of GIST. However, some problems remained. Both basic and clinical research is necessary to increase the therapeutic efficacy of IM.
-
Gan To Kagaku Ryoho · Oct 2004
Case Reports[A case of metastatic gastrointestinal stromal tumor developing a resistance to STI571 (imatinib mesylate)].
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal tract characterized by the expression of a receptor that activates tyrosine kinase called c-kit. Since malignant GISTs are resistant to conventional radiation therapy and chemotherapy, recurrent or malignant GIST has an extremely poor prognosis even after surgical resection. The development of a tyrosine kinase inhibitor, STI571 (imatinib mesylate, Glivec, Gleevec), which inhibits the BCR-ABL, PDGF-R alpha and c-kit receptors, has changed the management of unresectable malignant GIST and has improved the survival of patients with metastatic disease. ⋯ After the interruption of the treatment, an additional point mutation arose in exon 13 that caused a resistance to STI571. Currently STI571 is the first-line therapy for non-resectable GISTs, but a single-agent therapy often leads to tumor resistance. It is our hope that we will be able to design an alternative treatment to overcome such resistance.
-
Gan To Kagaku Ryoho · Aug 2004
[Prospective payment system of medical cost and surgical cancer treatment].
The process of introducing a prospective payment system after DRG or DPC in Japan was reviewed. The effect of DPC/PPS on surgical practice was discussed. Many problems resulted in the USA by introducing the DRG/PPS system. The rapid introduction of DPC/PPS in Japan only to reduce the total medical costs may bring about undesirable results for cancer patients.
-
Recently, it has become clearer that abnormal epigenetics is profoundly involved in many human diseases. Histone acetylation is one of the important mechanisms by which epigenetics is controlled. Reversible histone acetylation, which occurs at conserved lysine residues clustered near the amino-terminus of core histones, mediates changes in nucleosome conformation and transcriptional activity. ⋯ Some of the HDAC inhibitors are currently under clinical investigations. Therefore, HDAC has been considered as a molecular target for cancer therapy. We are providing a service for evaluating the HDAC inhibitory activity of compounds that are sent to the screening committee.