Biomedical subjects

Toshiharu Kamura

Publications and source records attributed to Toshiharu Kamura.

25 records · Page 2Linked to original sources

PubMed2002

Irinotecan (CPT-11) and cisplatin as first-line chemotherapy for advanced ovarian cancer.

OBJECTIVE: To evaluate the efficacy and toxicity of a combination of irinotecan (CPT-11) and cisplatin as first-line chemotherapy in advanced ovarian cancer. METHODS: Twenty-six patients with previously untreated advanced epithelial ovarian cancer were enrolled in this study. CPT-11 60 mg/m(2) was administered intravenously on days 1, 8, and 15 in combination with cisplatin 60 mg/m(2) on day 1. Cycles were repeated every 28 days for at least two cycles. The median patient age was 55 years (range, 37-75), and the median performance status was 1. RESULTS: Objective responses were recorded in 19 of 25 eligible patients (76%; 95% confidence interval, 55-91%). Complete responses were obtained in 2 patients (8%), and partial response in 17 patients (68%). Stable disease was recorded in 2 patients (8%) and progressive disease in 2 (8%). The median time to response was 62 days (range, 28-234 days). The median survival time for all 25 patients was 30.9+ months (range, 4.1-60.0+ months). The major toxic effects were leukopenia, neutropenia, and diarrhea. Grade 3 or 4 leukopenia, neutropenia, and diarrhea occurred in 17 (68%), 20 (83.3%), and 5 patients (20%), respectively. Thrombocytopenia was less common. No treatment-related deaths occurred. CONCLUSION: The combination of CPT-11 and cisplatin showed significant activity in chemotherapy-naive patients with advanced ovarian cancer. Neutropenia was the dose-limiting adverse effect, whereas diarrhea was mainly mild to moderate.

Adult↗

PubMed2002

Pitfall in chemotherapy for ovarian cancer.

Concerning the biological properties of recurrent ovarian cancer, other than drug resistance, we revealed that the expressions of mutant p53 and CD44v6 genes were significantly greater in recurrent ovarian cancer than in those of its primary counterpart. These findings suggest that chemotherapeutic agents may modify some biological characteristics of cancer by altering gene expressions. The biological behavior concerning the metastatic potential of a recurrent disease must be elucidated in order to develop an optional treatment regimen against recurrent tumors. Therefore, we established in-vivo cisplatin-resistant cell lines by repeated administration, in order to find a more suitable model for reflecting the biological aggressiveness of clinically recurrent ovarian cancer following chemotherapy. Chemotherapeutic agents have given a substantial advantage to cancer patients. It must be borne in mind that the cancer cells surviving following chemotherapy possibly present different biological properties from primary cancer cells, and that these properties might be developed by the chemotherapeutic agents.

Cell Movement↗

PubMed2002

Lymph node metastasis in a gynecologic malignancy.

A radical hysterectomy was performed on patients with stage IA2 to IIB cervical cancer. For these patients, many histopathological parameters have been reported to be prognostic factors of cervical cancer, such as a pelvic lymph node (PLN) metastasis, the histological subtype, the tumor diameter, the depth of the stromal invasion, a lymph-vascular space invasion (LVSI), a parametrial invasion, a corpus invasion and a vaginal invasion. Ovarian cancer is normally treated with cytoreductive surgery followed by chemotherapy. Although physicians have paid a great deal of attention to intraperitoneal disease, a substantial number of ovarian cancers have reported to involve the retroperitoneal lymph nodes. Therefore, a lymph node metastasis has been introduced into FIGO staging. However, the prognostic significance of a lymph node metastasis is controversial. In order to determine the possibility of individualizing a pelvic lymph node (PLN) dissection in patients with endometrial cancer, the relationship between PLN metastasis and the various prognostic factors was investigated. In this paper, various prognostic variables including a lymph node metastasis were analyzed in cervical cancer, endometrial cancer, and ovarian cancer.

Endometrial Neoplasms↗

PubMed2002

[A case of extraovarian primary peritoneal carcinoma successfully treated with weekly paclitaxel].

We report the use of paclitaxel in the successful treatment of a 74-year-old patient with extraovarian primary peritoneal carcinoma and acute renal failure caused by intraperitoneal cisplatin. The histological diagnosis was papillary serous adenocarcinoma. Paclitaxel was given intravenously at 70 mg/m2 in a 1-hour infusion weekly for 6 consecutive weeks followed by 2-weeks rest (one cycle). Toxicities including neutropenia and neurotoxicity were mild. She showed a clinical response after three cycles, and then underwent secondary cytoreductive surgery after which she received one additional cycle of therapy. She enjoyed a favorable quality of life without evidence of disease for 16 months after the completion of this therapy. Weekly 1-hour paclitaxel (70 mg/m2) was well tolerated, yet was effective for extraovarian primary peritoneal carcinoma.

Acute Kidney Injury↗

PubMed2002

[Treatment of malignant ovarian germ cell tumor and sex cord tumors].

We outline chemotherapy mainly for malignant ovarian germ cell and sex-cord tumors, based on studies in the literature and our own clinical experiences. With both tumors, PEB treatment is standard adjuvant chemotherapy. With regard to the number of dosage courses, 4 courses are regarded as tolerable after incomplete reduction, and 3 courses as adjuvant treatment after complete extraction. This chemotherapy is effective for preservation of fertility in young patients with malignant ovarian germ cell tumor. In both tumors, some cases show chemotherapy resistance. An effective second-line treatment strategy using a new anticancer agent needs to be established for such cases in the future.

Adolescent↗

PubMedDate not supplied

Vaccination with predesignated or evidence-based peptides for patients with recurrent gynecologic cancers.

Two different trials of peptide vaccination were conducted for patients with recurrent gynecologic cancers. In the first regimen, four HLA-A24+ patients (two with cervical cancer and two with ovarian cancer) were vaccinated with peptides that were predesignated before vaccination. Three patients exhibited with a grade 1 adverse effect, and no clinical response was observed in any patients. In the second regimen, six HLA-A24+ and four HLA-A2+ patients (five with cervical cancer, one with endometrial cancer, one with uterine sarcoma, and three with ovarian cancer) were vaccinated with peptides (maximum four) to which preexisting cytotoxic T lymphocyte precursors in the periphery were confirmed before vaccination. With this regimen, grade 1 adverse effects were observed in eight patients, a grade 2 adverse effect in one patient, and a grade 3 adverse effect (ie, rectal bleeding) in one patient. However, this regimen was able to enhance peptide-specific cytotoxic T lymphocytes in seven of ten patients, and three of five cervical cancer patients showed objective tumor regression. Analysis of immunoglobulin G -reactive to administered peptides suggested that the induction of peptide-specific immunoglobulin G was correlated with clinical responses. Overall, these results suggest that peptide vaccination of patients showing evidence of preexisting peptide-specific cytotoxic T lymphocyte precursors could be superior to vaccination with predesignated peptides, and that the evidence-based regimen is applicable for clinical trials in treatment of patients with recurrent gynecologic cancers.

Adult↗

PubMedDate not supplied

Clinical assessment of neoadjuvant chemotherapy and interval cytoreductive surgery for unresectable advanced ovarian cancer.

Sixty-five patients with unresectable advanced epithelial ovarian cancer who underwent exploratory laparotomy or unilateral oophorectomy were reviewed. Forty-five of 65 patients received 3.8 cycles of neoadjuvant chemotherapy (NAC) and were successfully debulked at interval cytoreductive surgery (IRS); 31 of 45 showed no evidence of disease. Patients with residuals <1 cm at IRS had a high possibility of achieving clinical remission. Patients who failed to receive IRS showed poor prognosis. Also, 63 patients who underwent conventional primary debulking surgery with residuals >1 cm were investigated as a contrast. No significant difference was observed in patient survival between the NAC group and the conventional treatment group. NAC and IRS offered patients with unresectable tumors survival similar to that of those with suboptimally resectable tumors at primary debulking. We conclude that this strategy has potential benefits for the patients with clinically aggressive ovarian cancer who are unable to receive standard treatment.

Aged↗