Irinotecan monotherapy was relatively safely performed as salvage-line treatment for AGC in Japanese clinical practice. Careful patient selection and intensive modification of the dose of irinotecan might possibly be associated with favorable survival.

BackgroundNuclear protein in testis (NUT) carcinoma (NC) is a rare epithelial malignancy characterized by rearrangement of the NUT gene on chromosome 15. If NC is not suspected, it is often diagnosed as other malignancies. We present the case of NC of the nasal cavity that responded to a chemotherapy regimen for Ewing’s sarcoma family of tumors (ESFT).Case presentationA 49-year-old male presented with epistaxis and pain in the left eye. The patient had a tumor in the left nasal cavity at initial visit and it was biopsied. Firstly, the man was diagnosed with ESFT based on a histopathological examination. The tumor markedly responded to standard cytotoxic chemotherapy for ESFT with distant metastasis. After the start of therapy, a chromosomal analysis revealed an atypical translocation in ESFT and additional immunostaining was positive for anti-NUT antibody. Ultimately, the patient was definitively diagnosed with NC. He received multidisciplinary therapy and symptoms were temporarily relieved. However, he died 9 months after the diagnosis of NC.ConclusionsWhen a pathologically undifferentiated tumor is evident along the midline of the body, NC must be included in the differential diagnosis, and immunohistochemical staining or genetic testing/chromosomal analysis needs to be performed.

Abstract. Background: Significant efficacy of oxaliplatinbased chemotherapy has been demonstrated for advanced gastric cancer (AGC).Gastric cancer (GC) is the fourth most frequent malignant tumor and the second most common cause of tumor death in the world (1). Recurrent GC after curative resection and initially unresectable metastatic GC (advanced GC; AGC) are treated with systemic chemotherapy (CT), that can prolong survival and maintain quality of life. For the initial CT, combination consisting of fluorouracil or fluoropyrimidine and platinum has been demonstrated to be effective. The triplet regimen including fluoropyrimidine, platinum and epirubicin is often used in European countries (2). Effectiveness of a triplet of docetaxel, cisplatin and fluorouracil has been shown in the United States (3). The standard therapy for patients with AGC in Japan has been a combination of the oral fluoropyrimidine S-1 and cisplatin (SP) based on the results of the phase 3 SPIRITS study (4). Another fluoropyrimidine, capecitabine, has also been shown to be effective for AGC in combination with cisplatin (5).Oxaliplatin has also been employed for systemic CT for AGC in combination with fluorouracil or fluoropyrimidine 2663