臨床外科68巻9号

2013年09月発行

特集 大腸癌腹膜播種を極める―最近の進歩と今後の展望

大腸癌腹膜播種に対する免疫療法―癌ペプチドワクチン療法

著者： 松田健司¹ 山上裕機¹

所属機関： ¹和歌山県立医科大学・第2外科

ページ範囲：P.1052 - P.1055

【ポイント】

◆大腸癌腹膜播種は他の転移部位と比較して予後は不良であるが，肉眼的根治切除により長期生存が期待できる．

◆進行再発大腸癌に対するペプチドワクチン療法の臨床試験が施行され，免疫応答を認める症例は生存期間を延長できる可能性が示されてきている．

参考文献

1）Franko J, Shi Q, Goldman CD, et al：Treatment of colorectal peritoneal carcinomatosis with systemic chemotherapy：a pooled analysis of north central cancer treatment group phase III trials N9741 and N9841. J Clin Oncol 30：263-267, 2012

2）Lemments V, Klaver Y, Verwaal V, et al：Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin：a population-based study. Int J Cancer 128：2717-2725, 2011

3）Matsuda K, Hotta T, Takifuji K, et al：Clinical impact of macroscopically complete resection of colorectal cancer with peritoneal carcinomatosis. Surgery 151：238-244, 2012

4）Matsuda K, Hotta T, Takifuji K, et al：Lymph node ratio is associated with the survival of colorectal cancer with peritoneal carcinomatosis. Am Surg 77：602-607, 2011

5）Elias D, Gilly F, Boutitie F, et al：Peritoneal colorectal carcinomatosis treated with surgery and perioperative intraperitoneal chemotherapy：retrospective analysis of 523 patients from a multicentric French study. J Clin Oncol 28：63-68, 2010

6）Schwartzentruber D, Lawson D, Richard J, et al：gp100 peptide vaccine and interleukin-2 in patients with advanced melanoma. N Engl J Med 364：2119-2127, 2011

7）Matsuda K, Tsunoda T, Tanaka H, et al：Enhancement of cytotoxic T-lymphocyte responses in patients with gastrointestinal malignancies following vaccination with CEA peptide-pulsed dendritic cells. Cancer Immunol Immunother 53：609-616, 2004

8）奥野清隆，杉浦史哲，塩崎　均：標準治療抵抗性の再発大腸癌に対するがんペプチドワクチン免疫化学療法の安全性と臨床効果．日臨外医会誌71：2249-2254, 2010

9）Matsushita N, Aruga A, Inoue Y, et al：Phase I trial of a peptide vaccine combined with tegafur-uracil plus leucovorin for treatment of advanced or recurrent colorectal cancer. Oncol Rep 29：951-959, 2013

10）Katsuda M, Iwahashi M, Matsuda K, et al：Comparison of different classes of CpG-ODN in augmenting the generation of human epitope peptide-specific CTLs. Int J Oncol 39：1295-1302, 2011

11）Iwahashi M, Katsuda M, Nakamori M, et al：Vaccination with peptides derived from cancer-testis antigens in combination with CpG-7909 elicits strong specific CD8＋T cell response in patients with metastatic esophageal squamous cell carcinoma. Cancer Sci 101：2510-2517, 2010

12）Hodi FS, O'Day S, McDermott D, et al：Improved survival with Ipilimumab in patients with metastatic melanoma. N Engl J Med 363：711-723, 2010