Paclitaxel chemotherapy for the treatment of gastric cancer

Abstract

cause of cancer mortality. Although the incidence of gastric cancer has been declining in most developed countries, esophago-gastric junctional tumor and tumor in the cardia has, conversely, been increasing [2] and these tumors still remain one of the biggest problems worldwide.The prognosis of patients with advanced (i.e., unresectable or metastatic) gastric cancer is very poor. The median survival time for such patients is 6 to 9 months [3]. For many years, various chemotherapeutic agents have been used in attempts to improve survival, progression free-survival, response rate, and quality of life in patients with advanced gastric cancer as well as to improve disease-free survival in patients in whom curative resection of the cancers has been performed. 5-Fluorouracil (5-FU) and cisplatin-based regimens have long been considered reference treatments. Commonly used regimens have included epirubicin, cisplatin, and continuous infusion of 5-FU; 5 days' infusion of 5-FU plus cisplatin every 4 weeks; a weekly infusion regimen of 5-FU/leucovorin (LV) over 24 h plus cisplatin every 2 weeks; and 5-FU bolus plus 22-h infusion of 5-FU on days 1 and 2, in combination with cisplatin every 2 weeks. The results with these regimens, together with other study results, suggested that combination regimens including fl uorinated pyrimidines, cisplatin, doxorubicin, epirubicin, and methotrexate, had better response rates than single agents. Although gastric cancer is a relatively chemosensitive disease, with response rates of 30% to 40%, these treatments have shown a modest but unsatisfactory increase in overall survival [4]. In this regard, chemotherapy in the advanced gastric cancer setting is limited by a low complete response rate, response durations that are shortlived, and considerable toxicities.Nevertheless, recently, the development of new chemotherapeutic and molecular targeting agents has opened the door to various clinical trials to fi nd novel therapeutic strategies to improve the outcome of Abstract A comprehensive review of phase I and phase II clinical trials of paclitaxel and paclitaxel-containing chemotherapy regimens for advanced gastric cancer was performed. Response rates, median progression-free survivals, and median overall survivals were examined, together with the treatment regimens and the numbers of patients registered in each trial. Although paclitaxel monotherapy produced considerable improvement in tumor response and prognosis, combination doublet or triplet chemotherapy with fl uoropyrimidines and/ or platinum compounds showed better results than the paclitaxel monotherapy. With regard to the schedule of paclitaxel administration, weekly injection seemed to show less toxicity and better results than administration every 3 weeks. Adjuvant therapies, chemoradiation therapies, and paclitaxel treatment for gastric ascites were also investigated and are discussed.

Human cytotoxic T-lymphocyte membrane-camouflaged nanoparticles combined with low-dose irradiation: a new approach to enhance drug targeting in gastric cancer

“…3 Previous studies 4,5 have demonstrated that systemic chemotherapy for palliation is advisable for this cohort to improve survival. Paclitaxel (PTX) is the most common hydrophobic, chemotherapeutic drug used in gastric cancer treatment, 6 but it also exhibits significant adverse effects because of the drug itself and the co-administered solvent. accumulate at tumor sites by incorporating targeting ligands on the nanoparticle surface.…”

Factors predicting peritoneal recurrence in advanced gastric cancer: implication for adjuvant intraperitoneal chemotherapy

“…Peritoneal dissemination is still the most common pattern of recurrence even in patients who receive adjuvant chemotherapy, although adjuvant chemotherapy definitely improves overall survival [4][5][6]. Some chemotherapeutic drugs, such as paclitaxel, are considered to be effective for peritoneal metastasis because of the efficient peritoneal penetration from the blood [7]; however, most systemic chemotherapeutic agents are not effective for peritoneal recurrence because of the bloodperitoneum barrier. In this regard, intraperitoneal chemotherapy (IPC) can be considered as an additional adjuvant therapy for AGC.…”

Harmine combined with paclitaxel inhibits tumor proliferation and induces apoptosis through down-regulation of cyclooxygenase-2 expression in gastric cancer

“…80-23, revised 1996) and the institutional ethical guidelines for animal experiments. The mice were subcutaneously injected into the left axillary space with 0.1 ml of cell suspension containing 4-6x10 6 SGC-7901 cells. Seven days after implantation of tumor cells (when the tumor size was ~0.1-0.2 cm 3 ), mice were randomly divided into four groups (n=6) to receive different treatments.…”

“…As a standard anticancer drug, paclitaxel (PTX) serves a significant role in the treatment of a number of tumors. As reported in latest studies, the efficiency of single anticancer drug-paclitaxel reaches 11-23% in treating the gastric cancer of middle and advanced stages, while that of drug combination therapy is 50-60% (6). Harmine (HM), originally isolated from the seeds of Peganum harmala, is a tricyclic compound belonging to the β-carboline alkaloids.…”