homocamptothecin and Stomach-Neoplasms

To observe the therapeutic effects and toxicity of HLF (hydroxycamptothecin HCPT/leucovorin LV/fluorouracil 5-Fu) regimen and ELF (etoposide VP-16/LV/5-Fu) regimen in middle-aged and elderly patients with advanced gastric carcinoma.. A group of twenty-five cases were treated with HLF regimen, and the other group of 23 cases were treated with ELF regimen.. Of the 25 cases treated with HLF regimen, there was no complete remission (CR), but there were 12 partial response (PR), 11 no response (NC), and 2 had progressive disease (PD). The response rate (RR) was 48.0%. Of the 23 patients treated with ELF regimen, there was no CR, there were 9 PR, 11 NC, and 3 PD. The RR was 39.1% (P > 0.05). The main toxicity was myelosuppression and stomatocace. Grade III-IV stomatocace in HLF regimen group (68.0%) was more commonly seen than that in ELF regimen group (39.1%, P < 0.05). There was no cardiac or renal toxicity observed.. HLF regimen is promising for treatment of advanced gastric carcinoma in middle-aged and elderly patients with the merits of low toxicity affecting heart, kidney and bladder except stomatocace, which is worthy of further clinical trial.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Etoposide; Female; Fluorouracil; Humans; Leucovorin; Male; Middle Aged; Neoplasm Staging; Stomach Neoplasms

To investigate the relationship between P-glycoprotein (Pgp), glutathione S-transferase π (GST-π) and topoisomerase II (Topo II) expression and human gastric cancer chemoresistance in vitro.. Primary single-cell suspensions were prepared from fresh specimens of primary gastric cancer and exposed to hydroxycamptothecin (HCPT), cisplatin (CDDP), 5-fluorouracil (5-FU), adriamycin (ADM) and mitomycin (MMC) for 48 h. Cell metabolic activity and rate of inhibition were evaluated using tetrazolium (MTT) assay. Pgp, GST-π and Topo II expression was determined in gastric carcinoma tissue samples using immunohistochemistry.. Chemosensitivity of the gastric cancer cells varied; the rates of inhibition of cells exposed to HCPT, CDDP and 5-FU were significantly higher than that of cells exposed to ADM and MMC (p < 0.05). Gastric cancer cells with Pgp expression were resistant to ADM and HCPT (p = 0.008 and p = 0.011, respectively). Cells resistant to 5-FU, CDDP and MMC had significantly higher GST-π expression (p < 0.05). Topo II expression was significantly lower in cells resistant to HCPT, ADM and MMC (p < 0.05). Pgp and GST-π expression may contribute to primary resistance of gastric cancer cells to some chemotherapeutic drugs, while Topo II expression may indicate HCPT, ADM and MMC sensitivity.. Pgp, GST-π and Topo II detection and the MTT assay could be used as predictors in chemotherapeutic drug administration and for identifying drug resistance in gastric carcinoma.. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/3448329111142964.

Topics: Antineoplastic Agents; ATP Binding Cassette Transporter, Subfamily B, Member 1; Camptothecin; Cells, Cultured; Cisplatin; DNA Topoisomerases, Type II; Doxorubicin; Drug Resistance, Neoplasm; Fluorouracil; Gastric Mucosa; Glutathione S-Transferase pi; Humans; In Vitro Techniques; Mitomycin; Stomach; Stomach Neoplasms