Clinical potential of biological response modifiers combined with chemotherapy for gastric cancer. Japanese experience.
The most effective treatment for gastric cancer is complete surgical resection with lymphadenectomy. However, a number of patients experience recurrence of the cancer even after curative surgery. This review focuses on comparative trials studying the use of adjuvant therapy with chemotherapy plus immunotherapy in the treatment of patients with curatively resected gastric cancer. Preoperative and intraperitoneal therapy, and therapy for advanced or recurrent gastric cancer are also discussed. At present, some subset analyses of adjuvant trials have shown favorable results suggesting that the biological response modifiers (BRMs), PSK or OK-432, add a benefit to chemotherapy. For advanced gastric cancer, although gastric cancer cells are generally not very sensitive to most of the currently available chemotherapeutic agents, it has been reported that biochemical modulation with treatments including low-dose cisplatin + 5-FU (fluorouracil) have high response rates and exert an immunomodulatory effect especially when used in combination with BRMs. The impact of splenectomy and some of the promising newly developed drugs are discussed.
First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan. mshibata@med.nihon-u.ac.jp
Masahiko
M
Shibata
Takeshi
T
Nezu
Shigeru
S
Fujisaki
Katsuyuki
K
Andou
Ryouichi
R
Tomita
Masahiro
M
Fukuzawa
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D016685:Mitomycin / Q000627:therapeutic use; D010844:Picibanil / Q000627:therapeutic use; D011509:Proteoglycans / Q000627:therapeutic use; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000601:surgery*
D000276:Adjuvants, Immunologic; D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D007155:Immunologic Factors; D011509:Proteoglycans; D010844:Picibanil; C010770:polysaccharide-K; D016685:Mitomycin