胃癌の腹膜転移に対する腹腔内化学療法
The survival outcomes of gastric cancer patients with peritoneal metastases are still dismal, even with recentadvances in chemotherapy. Paclitaxel is an antineoplastic agent with high molecular weight and hydrophobic features. It has a pharmacokinetic advantage for the control of peritoneal lesions....
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| Published in | 日大医学雑誌 Vol. 80; no. 6; pp. 297 - 301 |
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| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本大学医学会
01.12.2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0029-0424 1884-0779 |
| DOI | 10.4264/numa.80.6_297 |
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| Abstract | The survival outcomes of gastric cancer patients with peritoneal metastases are still dismal, even with recentadvances in chemotherapy. Paclitaxel is an antineoplastic agent with high molecular weight and hydrophobic features. It has a pharmacokinetic advantage for the control of peritoneal lesions. After intraperitoneal delivery usingan implantable peritoneal access port, it slowly exits the peritoneal cavity, resulting in reduced systemic uptakeand toxicity, as well as sustained high concentrations in the peritoneal cavity. Intraperitoneal paclitaxel plus S-1and intravenous paclitaxel therapy was developed, and phase II trials were conducted to evaluate the efficacy forgastric cancer patients with peritoneal disease. Although two trials showed promising results, a subsequent phaseIII trial failed to show statistical superiority over S-1 plus cisplatin doublet systemic chemotherapy. I reviewed thehistorical background of this therapy and discussed its pros and cons. |
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| AbstractList | The survival outcomes of gastric cancer patients with peritoneal metastases are still dismal, even with recentadvances in chemotherapy. Paclitaxel is an antineoplastic agent with high molecular weight and hydrophobic features. It has a pharmacokinetic advantage for the control of peritoneal lesions. After intraperitoneal delivery usingan implantable peritoneal access port, it slowly exits the peritoneal cavity, resulting in reduced systemic uptakeand toxicity, as well as sustained high concentrations in the peritoneal cavity. Intraperitoneal paclitaxel plus S-1and intravenous paclitaxel therapy was developed, and phase II trials were conducted to evaluate the efficacy forgastric cancer patients with peritoneal disease. Although two trials showed promising results, a subsequent phaseIII trial failed to show statistical superiority over S-1 plus cisplatin doublet systemic chemotherapy. I reviewed thehistorical background of this therapy and discussed its pros and cons. |
| Author | 山下, 裕玄 |
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| References | 1) Inoue M. Changing epidemiology of Helicobacter pylori in Japan. Gastric cancer. 2017; 20: 3–7. 7) Markman M, Rowinsky E, Hakes T, et al. Phase I trial of intraperitoneal taxol: a Gynecoloic Oncology Group study. J Clin Oncol. 1992; 10: 1485–1491. 8) Francis P, Rowinsky E, Schneider J, et al. Phase I feasibility and pharmacologic study of weekly intraperitoneal paclitaxel: a Gynecologic Oncology Group pilot Study. J Clin Oncol. 1995; 13: 2961–2967. 18) Emoto S, Ishigami H, Hidemura A, et al. Complications and management of an implanted intraperitoneal access port sys tem for intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis. Jpn J Clin Oncol. 2012; 42: 1013–1019. 9) Armstrong DK, Bundy B, Wenzel L, et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006; 354: 34–43. 12) Kobayashi M, Sakamoto J, Namikawa T, et al. Pharmacokinetic study of paclitaxel in malignant ascites from advanced gastric cancer patients. World J Gastroenterol. 2006; 12: 1412–1415. 13) Narahara H, Fujitani K, Takiuchi H, et al. Phase II study of a combination of S-1 and paclitaxel in patients with unresect able or metastatic gastric cancer. Oncology. 2008; 74: 37–41. 10) Walker JL, Armstrong DK, Huang HQ, et al. Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer: a Gynecologic Oncology Group Study. Gynecol Oncol. 2006; 100: 27–32. 20) Kitayama J, Ishigami H, Kaisaki S, et al. Weekly intravenous and intraperitoneal paclitaxel combined with S-1 for malig nant ascites due to advanced gastric cancer. Oncology. 2010; 78: 40–46. 3) Katai H, Maruyama K, Sasako M, et al. Mode of recurrence after gastric cancer surgery. Dig Surg. 1994; 11: 99–103. 11) Wiernik PH, Schwartz EL, Strauman JJ, et al. Phase I clinical and pharmacokinetic study of taxol. Cancer Res. 1987; 47: 2486–2493. 5) Sautner T, Hofbauer F, Depisch D, et al. Adjuvant intraperitoneal cisplatin chemotherapy does not improve long-term sur vival after surgery for advanced gastric cancer. J Clin Oncol. 1994; 12: 970–974. 6) Miyashiro I, Furukawa H, Sasako M, et al. Randomized clinical trial of adjuvant chemotherapy with intraperitoneal and intravenous cisplatin followed by oral fluorouracil (UFT) in serosa-positive gastric cancer versus curative resection alone: final results of the Japan Clinical Oncology Group trial JCOG9206-2. Gastric cancer. 2011; 14: 212–218. 2) Fukagawa T, Katai H, Saka M, et al. Significance of lavage cytology in advanced gastric cancer patients. World J Surg. 2010; 34: 563–568. 17) Ishigami H, Fujiwara Y, Fukushima R, et al. Phase III Trial Comparing Intraperitoneal and Intravenous Paclitaxel Plus S-1 Versus Cisplatin Plus S-1 in Patients With Gastric Cancer With Peritoneal Metastasis: PHOENIX-GC Trial. J Clin Oncol. 2018; 36: 1922–1929. 16) Yamaguchi H, Kitayama J, Ishigami H, et al. A phase 2 trial of intravenous and intraperitoneal paclitaxel combined with S-1 for treatment of gastric cancer with macroscopic peritoneal metastasis. Cancer. 2013; 119: 3354–3358. 14) Ishigami H, Kitayama J, Otani K, et al. Phase I pharmacokinetic study of weekly intravenous and intraperitoneal paclitaxel combined with S-1 for advanced gastric cancer. Oncology. 2009; 76: 311–314. 4) Rosen HR, Jatzko G, Repse S, et al. Adjuvant intraperitoneal chemotherapy with carbon-adsorbed mitomycin in patients with gastric cancer: results of a randomized multicenter trial of the Austrian Working Group for Surgical Oncology. J Clin Oncol. 1998; 16: 2733–2738. 15) Soma D, Kitayama J, Konno T, et al. Intraperitoneal administration of paclitaxel solubilized with poly(2-methacryloxyeth yl phosphorylcholine-co n-butyl methacrylate) for peritoneal dissemination of gastric cancer. Cancer Sci. 2009; 100: 1979 19) 日本胃癌学会．胃癌治療ガイドライン第6 版．金原出版株式会社，2021. |
| References_xml | – reference: 5) Sautner T, Hofbauer F, Depisch D, et al. Adjuvant intraperitoneal cisplatin chemotherapy does not improve long-term sur vival after surgery for advanced gastric cancer. J Clin Oncol. 1994; 12: 970–974. – reference: 13) Narahara H, Fujitani K, Takiuchi H, et al. Phase II study of a combination of S-1 and paclitaxel in patients with unresect able or metastatic gastric cancer. Oncology. 2008; 74: 37–41. – reference: 18) Emoto S, Ishigami H, Hidemura A, et al. Complications and management of an implanted intraperitoneal access port sys tem for intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis. Jpn J Clin Oncol. 2012; 42: 1013–1019. – reference: 2) Fukagawa T, Katai H, Saka M, et al. Significance of lavage cytology in advanced gastric cancer patients. World J Surg. 2010; 34: 563–568. – reference: 17) Ishigami H, Fujiwara Y, Fukushima R, et al. Phase III Trial Comparing Intraperitoneal and Intravenous Paclitaxel Plus S-1 Versus Cisplatin Plus S-1 in Patients With Gastric Cancer With Peritoneal Metastasis: PHOENIX-GC Trial. J Clin Oncol. 2018; 36: 1922–1929. – reference: 6) Miyashiro I, Furukawa H, Sasako M, et al. Randomized clinical trial of adjuvant chemotherapy with intraperitoneal and intravenous cisplatin followed by oral fluorouracil (UFT) in serosa-positive gastric cancer versus curative resection alone: final results of the Japan Clinical Oncology Group trial JCOG9206-2. Gastric cancer. 2011; 14: 212–218. – reference: 8) Francis P, Rowinsky E, Schneider J, et al. Phase I feasibility and pharmacologic study of weekly intraperitoneal paclitaxel: a Gynecologic Oncology Group pilot Study. J Clin Oncol. 1995; 13: 2961–2967. – reference: 9) Armstrong DK, Bundy B, Wenzel L, et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006; 354: 34–43. – reference: 10) Walker JL, Armstrong DK, Huang HQ, et al. Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer: a Gynecologic Oncology Group Study. Gynecol Oncol. 2006; 100: 27–32. – reference: 15) Soma D, Kitayama J, Konno T, et al. Intraperitoneal administration of paclitaxel solubilized with poly(2-methacryloxyeth yl phosphorylcholine-co n-butyl methacrylate) for peritoneal dissemination of gastric cancer. Cancer Sci. 2009; 100: 1979– – reference: 14) Ishigami H, Kitayama J, Otani K, et al. Phase I pharmacokinetic study of weekly intravenous and intraperitoneal paclitaxel combined with S-1 for advanced gastric cancer. Oncology. 2009; 76: 311–314. – reference: 1) Inoue M. Changing epidemiology of Helicobacter pylori in Japan. Gastric cancer. 2017; 20: 3–7. – reference: 4) Rosen HR, Jatzko G, Repse S, et al. Adjuvant intraperitoneal chemotherapy with carbon-adsorbed mitomycin in patients with gastric cancer: results of a randomized multicenter trial of the Austrian Working Group for Surgical Oncology. J Clin Oncol. 1998; 16: 2733–2738. – reference: 11) Wiernik PH, Schwartz EL, Strauman JJ, et al. Phase I clinical and pharmacokinetic study of taxol. Cancer Res. 1987; 47: 2486–2493. – reference: 19) 日本胃癌学会．胃癌治療ガイドライン第6 版．金原出版株式会社，2021. – reference: 3) Katai H, Maruyama K, Sasako M, et al. Mode of recurrence after gastric cancer surgery. Dig Surg. 1994; 11: 99–103. – reference: 20) Kitayama J, Ishigami H, Kaisaki S, et al. Weekly intravenous and intraperitoneal paclitaxel combined with S-1 for malig nant ascites due to advanced gastric cancer. Oncology. 2010; 78: 40–46. – reference: 12) Kobayashi M, Sakamoto J, Namikawa T, et al. Pharmacokinetic study of paclitaxel in malignant ascites from advanced gastric cancer patients. World J Gastroenterol. 2006; 12: 1412–1415. – reference: 16) Yamaguchi H, Kitayama J, Ishigami H, et al. A phase 2 trial of intravenous and intraperitoneal paclitaxel combined with S-1 for treatment of gastric cancer with macroscopic peritoneal metastasis. Cancer. 2013; 119: 3354–3358. – reference: 7) Markman M, Rowinsky E, Hakes T, et al. Phase I trial of intraperitoneal taxol: a Gynecoloic Oncology Group study. J Clin Oncol. 1992; 10: 1485–1491. |
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| Title | 胃癌の腹膜転移に対する腹腔内化学療法 |
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