Gan to kagaku ryoho. Cancer & chemotherapy
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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.
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Leptomeningeal carcinomatosis is a serious complication leading to a fatal outcome in patients with gastric cancer. We tried to treat leptomeningeal carcinomatosis from gastric cancer with intrathecal chemotherapy using methotrexate (MTX)and cytosine arabinoside(Ara-C). We described and discussed the therapeutic strategy. ⋯ The survival of the intrathecal chemotherapy group was from 39 to 367 days, whereas the survival of the conservative treatment group was from 10 to 31 days. The intrathecal chemotherapy improved not only survival but also clinical symptoms dramatically. Intrathecal chemotherapy is thus recommended for leptomeningeal carcinomatosis from gastric cancer.
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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.
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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.
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Sunitinib malate(SU11248)is an oral multitargeted receptor tyrosine kinase inhibitor(MTI)that has antitumor activities for patients with gastrointestinal stromal tumor; GIST after failure of Imatinib. Sunitinib has demonstrated significant clinical benefits, including PFS, RR and OS in the USA and Japan. ⋯ Now, clinical trials of several new MTIs are ongoing in Western countries. Inhibition of the KIT gene cis-mutations and antiangiogenesis activities may be essential for the strategy for Imatinib/Sunitinibresistant GIST.