腎癌転移巣に対する動注化学療法 : MDR克服剤の併用

Abstract

MDR1遺伝子を高いレベルで発現する2種類の腎癌細胞を使い, cepを含む5種類のMDR克服剤のVBLに対する感受性増強効果を比較した。さらにcepの各種抗癌剤に対する感受性増強の有無とその程度を検討した。これらをもとにVBL, ADRまたはepi-ADRにcepを併用した動脈内注入化学療法を6症例の腎癌転移巣に対し行い, 骨転移の2症例で著しい治療効果がえられた。このようなP糖蛋白を標的とした化学療法は, 特にBRM療法に比較的抵抗性の骨転移病巣などに対しては, 有効な治療法になりえると考えられた

We analyzed the sensitizing activity of five agents, which have been assumed to be MDR-overcoming drugs, in two human renal cell carcinoma cell lines expressing the MDR1 gene at high levels. In addition, we studied the sensitizing activity of cepharanthin, an MDR-overcoming agents, to vinblastine, adriamycin, epirubicin, cisplatin, mitomycin C and etoposide. Based on the results, we treated 6 patients with metastatic renal cell carcinomas (4: bones, 2: contralateral kidneys) by intraarterial injection of vinblastine and adriamycin (or epirubicin) in combination with cepharanthin. Two of the 4 bone metastasis cases responded markedly to the treatment. Renal tubular impairment was observed in one patient who was treated for the contralateral kidney metastasis.