Neoadjuvant chemotherapy for pancreatic cancer: Effects on cancer tissue and novel perspectives

フォーマット:

論文

責任表示:

Tajima, Hidehiro ; Makino, Isamu ; Ohbatake, Yoshinao ; Nakanuma, Shinichi ; Hayashi, Hironori ; Nakagawara, Hisatoshi ; Miyashita, Tomoharu ; Takamura, Hiroyuki ; Ohta, Tetsuo

言語:

英語

出版情報:

Spandidos Publications, 2017-06-01

著者名:

Tajima, Hidehiro

Makino, Isamu

Ohbatake, Yoshinao

Nakanuma, Shinichi

Hayashi, Hironori

Nakagawara, Hisatoshi

Miyashita, Tomoharu

Takamura, Hiroyuki

Ohta, Tetsuo

続きを見る

掲載情報:

Oncology Letters

ISSN:

1792-1074      

巻:

13

通号:

6

開始ページ:

3975

終了ページ:

3981

バージョン:

publisher

概要:

Chemotherapy for pancreatic cancer has diversified following the addition of more treatment regimens; however, in spite of this, pancreatic cancer remains a fatal disease. Preoperative (neoadjuvant) chemotherapy (NAC) or neoadjuvant chemoradiation therapy (NACRT) has been developed and implemented. For patients with borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC), a number of clinical trials have been conducted; NACRT … was demonstrated to improve resectability, R0 resection rate, overall survival rate, disease-free survival rate and even an LAPC and BRPC survival advantage over NAC. However, from the knowledge obtained from resected specimens following preoperative treatment, residual pancreatic cancer tissues following NAC are rich in chemoresistant cancer stem-like cells and epithelial-mesenchymal transition (EMT) markers. Conversely, metformin, angiotensin receptor blocker, statins and low-dose paclitaxel are well-known as drugs that inhibit EMT, which is associated with cancer stem cell-like characteristics. Although clinical effectiveness is unlikely to be achieved using one of these as an anticancer agent, it is reasonable to use these drugs for patients with comorbidities in the treatment of pancreatic cancer. Furthermore, gemcitabine (GEM) affects antitumor immunity by stimulating the expression of major histocompatibility complex class I-related chain A on the surface of cancer cells to enhance the cytotoxicity of natural killer cells. Considering EMT and antitumor immunity, there is a possibility that GEM and nanoparticle albumin-bound paclitaxel therapy is the most suitable regimen for treating pancreatic cancer. However, even as preoperative treatment progresses, R0 resection is the most important factor for the long-term survival of pancreatic cancer patients. © 2017, Spandidos Publications. All rights reserved.<br />Embargo Period 6 months 続きを見る

URL:

http://hdl.handle.net/2297/48436