難治性悪性神経膠腫の治療戦略
スポンサーリンク
概要
- 論文の詳細を見る
Malignant gliomas are the most common primary central nervous system tumors. Standard therapy is surgical resection, where possible, and radiotherapy. Since adjuvant chemotherapy only provides a modest survival benefit, new therapies are necessary. Recently developed agents, such as temozolomide (TMZ), irinotecan, and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), have demonstrated efficacy against malignant gliomas. A novel oral alkylating agent, TMZ shows good penetration in the central nervous system, and it has largely replaced nitrosoureas in the treatment of gliomas. Recently, a randomized trial in which newly diagnosed glioma patients were treated with TMZ and radiation achieved enhanced survival rates. In particular, better survival rates were observed in patients with a methylated promotor of the O6-methylguanine-DNA methyltransferase (MGMT) gene which encodes an alkyltransferase. Another clinical study revealed that polymorphisms found in genes encoding topoisomerase I inhibitor irinotecan-metabolizing enzymes (UGT1A1) were associated with the occurrence of severe irinotecan-induced toxicity. Overexpression of EGFR appears to be correlated with the grade of glioma and it has been reported that specific mutations in the EGFR gene are correlated with clinical responsiveness to the EGFR-TKI gefitinib. In order to achieve innovative treatment strategies in the future, it is therefore important for clinical pharmacists to have a good understanding of glioma at the molecular level since this will help in identifying patients most likely to benefit from a specific therapy. We hope that personalized medication for glioma based on genetics will increase drug efficacy and prevent or reduce adverse reactions, which in turn will improve clinical outcomes and decrease the overall costs of therapy.
- 日本医療薬学会の論文
日本医療薬学会 | 論文
- O17-003 視覚障害者に対する手技指導の標準化を目的とした視覚障害擬似体験インスリン注射院内実習(一般演題 口頭発表,糖尿病/後発医薬品,医療薬学の創る未来 科学と臨床の融合)
- 20H-16 Basal-Bolus療法におけるインスリンデテミルの有効性(使用状況調査・意識調査,来るべき時代への道を拓く)
- 30-P2-43 2種類のインスリン試薬を用いた化学発光酵素免疫測定法によってFactitious hypoglicemiaを証明しえた一例(副作用・有害事象,社会の期待に応える医療薬学を)
- 28-04-20 ペン型インスリン注射器の精度に及ぼす注入時抵抗とカートリッジ内気泡の影響
- P-610 ファブリー病に対する「ファブラザイム^[○!R]」投与時の「過敏反応発現時の対処方法」の一部改変により副作用防止に至った1症例(8.有害事象・副作用(基礎と臨床)1,医療薬学の未来へ翔(はばた)く-薬剤師の薬剤業務・教育・研究への能動的関わり-)