Preliminary Individualized Chemotherapy for Malignant Astrocytomas Based on O^6-Methylguanine-Deoxyribonucleic Acid Methyltransferase Methylation Analysis
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概要
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O^6-methylguanine-deoxyribonucleic acid methyltransferase gene (MGMT) methylation is apparently correlated with responsiveness to nitrosourea chemotherapy, suggesting this alkylating agent should be effective against MGMT-methylated tumors. MGMT appears not to be linked to platinum resistance, so platinum chemotherapy should be used for MGMT-unmethylated tumors. This study was a preliminary trial of individualized chemotherapy based on MGMT methylation status in a total of 20 patients with newly diagnosed malignant astrocytomas (9 anaplastic astrocytomas and 11 glioblastomas multiforme). The procarbazine, 1-(4-amino-2-methyl-5-pyrimidinyl) methyl-3-2(2-chloroethyl)-3-nitrosourea, and vincristine (PAV) regimen was administered to seven patients with MGMT-methylated tumors, and the carboplatin and etoposide (CE) regimen was administered to 13 patients with MGMT-unmethylated tumors. Objective response to the PAV therapy was noted in all three patients with measurable residual tumor (2 complete responses and 1 partial response). Five of the seven patients continued to be diseasefree after initiation of the PAV therapy. Objective response to the CE therapy was seen in only one of seven patients with measurable residual tumor (1 partial response). Three of the 13 patients were free from progression, whereas the remaining 10 patients showed early progression. The PAV regimen is effective against MGMT-methylated malignant astrocytomas, but the CE regimen is not useful at the given dose and schedule in MGMT-unmethylated tumors.
- 2006-08-15
著者
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WATANABE Takao
Department of Environmental Health, Miyagi University of Education
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KATAYAMA Yoichi
Department of Neurological Surgery, Nihon University School of Medicine
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OGINO Akiyoshi
Department of Neurological Surgery, Nihon University School of Medicine
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OHTA Takashi
Department of Neurological Surgery, Nihon University School of Medicine
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YOSHINO Atsuo
Department of Neurological Surgery, Nihon University School of Medicine
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FUKUSHIMA Takao
Department of Neurological Surgery, Nihon University School of Medicine
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Yoshino Atsuo
Department Of Neurological Surgery Nihon University School Of Medicine
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Ogino Akiyoshi
Department Of Neurological Surgery Nihon University School Of Medicine
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Fukushima Takao
Department Of Neurological Surgery Nihon University School Of Medicine
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Katayama Yoichi
Department Of Neurological Surgery Nihon University School Of Medicine
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Katayama Yoichi
Division Of Neurosurgery Department Of Neurological Surgery Nihon University School Of Medicine
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Watanabe Takao
Division Of Neurosurgery Department Of Neurological Surgery Nihon University School Of Medicine
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Ohta Takashi
Department Of Neurological Surgery Nihon University School Of Medicine
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Ohta Takashi
Department Of Internal Medicine School Of Medicine Tokai University
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Ohta Takashi
Department Of Anesthesiology Toda Chuo Sougou Hospital
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Watanabe Takao
Department Of Applied Biology Kyoto Institute Of Technology
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Watanabe Takao
Departmant Of Mathematics Faculty Of Science Osaka University
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Katayama Yoichi
Department of Neurlogical Surgery, School of Medicine, Nihon University, Tokyo, Japan
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