Endoscopic local injection of a new drug-delivery format of peplomycin for superficial esophageal cancer: a pilot study.
BACKGROUND
A new drug-delivery format comprising activated carbon particles adsorbing peplomycin (PEP-CH) was developed for the treatment of superficial esophageal cancer.


METHODS
The drug distribution was measured in rats that received subcutaneous injections of PEP-CH or peplomycin aqueous solution. In 6 patients with superficial esophageal cancer, peplomycin as PEP-CH, 5-10 mg once a week for 4-10 weeks (total, 40-100 mg/patient) was injected endoscopically into primary lesions.


RESULTS
Rats given PEP-CH had significantly higher peplomycin levels in the regional lymph nodes and the injection site than rats given aqueous solution. Five patients have survived to the present or died without cancer after 27-72 months. The remaining patient has survived without cancer for 8 months after a second course of PEP-CH against recurrence.


CONCLUSIONS
PEP-CH therapy seems to have a good therapeutic effect on superficial esophageal cancer, although the present clinical study may have been biased by patient selection.
Hagiwara
A
A
First Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
Takahashi
T
T
Kojima
O
O
Kitamura
K
K
Sakakura
C
C
Shoubayashi
S
S
Osaki
K
K
Iwamoto
A
A
Lee
M
M
Fujita
K
K
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D004724:Endoscopy / Q000379:methods; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections / Q000379:methods; D008198:Lymph Nodes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D017663:Peplomycin; D010865:Pilot Projects; D051381:Rats; D011919:Rats, Inbred Strains; D014018:Tissue Distribution
D000903:Antibiotics, Antineoplastic; D001761:Bleomycin; D017663:Peplomycin