Photodynamic therapy: new treatment for refractory lymphocytic infiltration of the skin

Lymphocytic infiltration of the skin (LIS) is a relatively uncommon skin condition, first described by Jessner and Kanof in 1953. LIS presents mainly on the face, in particular on the cheeks and earlobe, but also on the neck, upper trunk or proximal limbs of middle-aged adults. LIS is often resistant to treatment. Photodynamic therapy (PDT) refers to the process of applying a topical prodrug, such as 5-aminolaevulinic acid (ALA) or methyl 5-aminolaevulinic acid (MAL), followed by irradiation with visible or ultraviolet light. The prodrug is converted by target tissue to photoactive porphyrins, which lead to local tissue destruction when activated by light. We describe a 48-year-old woman with refractory LIS, who was treated with MAL-PDT.

P2-10-09: Detecting Breast Cancer with Dynamic Diffuse Optical Tomographic Imaging

Background: Over the last decade diffuse optical tomography (DOT) has emerged as a novel medical imaging modality. Near-infrared light is used to non-invasively probe biological tissue, and three-dimensional (3D) maps of blood-dependent parameters can be obtained. Several studies are underway to show the clinical utility of DOT for imaging brain disease, joint disease, and breast cancer. Here we present the largest clinical study to date that uses hemodynamic effects caused by a simple breath hold to identify breast tumors using DOT.

Methods: We have designed and built a DOT breast imaging system that can acquire full 3D data sets within a fraction of a second. The system affords the ability to study fast hemodynamic effects in both breasts simultaneously. Using non-compressive imaging heads we measured the oxygenated and deoxygenated hemoglobin levels in the breasts of 15 patients whose mammogram showed a mass >1 cm (4 benign, 11 malignant) and 3 healthy controls. Data was acquired over the course of a 30-second breath hold and 30 seconds thereafter. In addition, a baseline measurement of 30 seconds prior to the breath hold was obtained. A multi-wavelength image reconstruction algorithm was used to create 3D maps of hemoglobin-dependent parameters (Δ[HbO2] and Δ[Hb]) in the breast every 0.58 seconds, over the course of the 90-second experiment. An image analysis algorithm identified regions of peak percentage change in [Hb] and [HbO2] in the breast and then computed the average hemoglobin levels in those regions.

Results: We observed an increase in the hemoglobin levels in all breasts during the breath hold. Upon resuming breathing, these hemoglobin levels returned to baseline. Tumor bearing breasts showed a statistically significant slower return to baseline than healthy breasts. In particular, we found that tumors can be detected by a substantially larger Δ[Hb] value as compared to normal tissue in images acquired 15 seconds following the end of the breath hold. In 10 of 11 patients the malignant tumor was identified using this technique, suggesting sensitivity over 90%. No regions of increased Δ[Hb] were seen in the healthy breasts, or in the breasts with benign masses. The peak percentage change in [Hb] at the 15 second post-breath hold time point was 10.0 ± 6.0% (n=11) in the malignant tumors compared to 1.4 ± 0.5% (n=3) (p=0.001) in healthy patients and 4.8 ± 1.9% in benign masses (n=4)(p=0.03).

Discussion: A breath hold impedes venous return to the heart, which causes pooling of blood in the breast. This is observed as an increase in [Hb] and [HbO2] using DOT. Tumor vasculature is known to be more disorganized, tortuous, and leakier than normal vasculature. Therefore, once the breath hold is released and blood is allowed to drain from the breast, blood accumulated in the tumor during the breath hold will drain more slowly than blood in healthy tissue. This study has shown that DOT allows us to visualize these hemodynamic effects and use them to detect tumors with a simple breath hold and compression-free imaging head. Future studies need to explore the detection limits and general clinical utility of this technique for screening, differentiating malignant from benign masses, and treatment monitoring.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-10-09.

The association between serum osteocalcin levels and metabolic syndrome in Koreans

The association between serum osteocalcin levels and metabolic syndrome (MS) in Korean individuals was investigated. Serum osteocalcin levels are significantly lower in subjects with MS than in those without the disease, regardless of glucose metabolism.

INTRODUCTION

Osteocalcin was recently shown to affect energy metabolism. In the present study, we investigated the possible association between serum osteocalcin concentrations and MS.

METHODS

A cross-sectional community-based survey was conducted. Serum osteocalcin, type 1 collagen C-telopeptide (CTX) and total alkaline phosphatase (ALP) concentrations were determined in 567 subjects. MS was defined according to NCEP-ATP III criteria.

RESULTS

Serum osteocalcin concentrations were significantly lower in subjects with MS than those without MS in postmenopausal women (18.923 ± 7.685 vs 22.513 ± 7.344 ng/ml, P<0.001) and marginally lower in subjects with MS than those without MS in men (14.550 ± 5.090 vs 16.125 ± 4.749 ng/ml, P=0.086) after adjustment for age and BMI. Further controlling with CTX or ALP did not affect this association in postmenopausal women; however, controlling with osteocalcin abolished the association between CTX and MS. Significant differences in serum osteocalcin levels by MS status were noted in subjects with normal glucose tolerance as well as those with abnormal glucose tolerance (P=0.032 and P<0.001, respectively). Compared with subjects with the highest quartile of osteocalcin, those in the lower quartile groups (Q1-Q3) had significantly increased risks of MS (ORs=5.18, CIs=1.15-23.42) in men. In postmenopausal women, the ORs for MS were significantly higher in the lowest quartile than in the highest quartile (ORs=5.25, CIs=2.42-11.36).

CONCLUSIONS

These findings suggest that osteocalcin is associated with MS, independently of glucose metabolism.

Genomic sequence of infectious hypodermal and hematopoietic necrosis virus (IHHNV) KLV-2010-01 originating from the first Korean outbreak in cultured Litopenaeus vannamei

Due to the need to track and monitor genetic diversity, the genome of the infectious hypodermal and hematopoietic necrosis virus (IHHNV) strain KLV-2010-01 in cultured Litopenaeus vannamei shrimp that originated from the first Korean outbreak in 2010 was sequenced and analyzed. The genome, with a length of 3914 nucleotides, was sequenced from the Korean IHHNV. The genome encoded three large and overlapping open reading frames: ORF1 (NS-1) of 2001 bp, ORF2 (NS-2) of 1092 bp and ORF3 (capsid protein) of 990 bp. The overall organization, size and predicted amino acid sequence of the three ORFs in Korean IHHNV were highly similar to those of members of the infectious IHHNV group, and the most closely related strains were IHHNVs described from Ecuador and Hawaii. Additionally, phylogenetic analysis showed that the Korean IHHNV was clustered with lineage III in the infectious IHHNV group and was most similar to IHHNV isolates from Ecuador, China and Taiwan.

AKR1B10 is associated with smoking and smoking-related non-small-cell lung cancer

This prospective study explored the relationship between expression of AKR1B10 mRNA and various clinical parameters in non-small-cell lung cancer (NSCLC) in terms of its validation as a marker for NSCLC. Tumour tissue samples were collected from 229 patients with NSCLC. Tissue samples from adjacent non-malignant lung tissue (> 5 cm from the tumour) of 89 of these patients and samples from 20 patients with benign lung disease were used as controls. Quantitative reverse transcription- polymerase chain reaction showed significantly higher levels of AKR1B10 mRNA expression in NSCLC tumour tissue than in adjacent non-malignant lung tissue and benign lung tissue. Statistically significant factors for AKR1B10 mRNA over-expression were found to be male gender, smoking, squamous cell carcinoma and moderate or poor cell differentiation. It is concluded that AKR1B10 seems to have potential as a prognostic marker for NSCLC and warrants further investigation.

Effect of garlic on high fat induced obesity

The present study was performed to examine the effects of garlic on obesity and blood lipid profiles in high-fat induced obesity mice model, and to elucidate the molecular mechanisms responsible for such effect. C57BL/6 mice were fed a standard diet (STD) or high-fat diet (HFD) for 5 weeks to induce obesity. Mice were then randomly divided into four groups with 10 mice per group, and fed experimental diet for 4 weeks; STD group, HFD group, HFD containing 2% or 4% garlic group (HFD + G2 or HFD + G4, respectively). Administration of garlic significantly reduced HFD-induced body weight, epididymal fat accumulation, hyperlipidemia and hypercholesterolemia. Consequently, the atherogenic indexes were reduced by 83% and 91%, respectively, in 2% and 4% garlic supplemented group. Liver steatosis induced by HFD was ameliorated by garlic supplementation. Furthermore, garlic affected the down regulation of expression patterns of epididymal adipose tissue genes such as peroxisome proliferator-activated receptor γ (PPARγ), acetyl CoA carboxylase (ACC), adipose specific fatty acid binding protein (aP2), and glycerol-3-phosphate dehydrogenase (GPDH). These results suggest that garlic may have a potential benefit in preventing obesity.

Gene expression signatures associated with the in vitro resistance to two tyrosine kinase inhibitors, nilotinib and imatinib

The use of selective inhibitors targeting Bcr-Abl kinase is now established as a standard protocol in the treatment of chronic myelogenous leukemia; however, the acquisition of drug resistance is a major obstacle limiting the treatment efficacy. To elucidate the molecular mechanism of drug resistance, we established K562 cell line models resistant to nilotinib and imatinib. Microarray-based transcriptome profiling of resistant cells revealed that nilotinib- and imatinib-resistant cells showed the upregulation of kinase-encoding genes (AURKC, FYN, SYK, BTK and YES1). Among them, the upregulation of AURKC and FYN was observed both in nilotinib- and imatinib-resistant cells irrespective of exposure doses, while SYK, BTK and YES1 showed dose-dependent upregulation of expression. Upregulation of EGF and JAG1 oncogenes as well as genes encoding ATP-dependent drug efflux pump proteins such as ABCB1 was also observed in the resistant cells, which may confer alternative survival benefits. Functional gene set analysis revealed that molecular categories of ‘ATPase activity', ‘cell adhesion' or ‘tyrosine kinase activity' were commonly activated in the resistant clones. Taken together, the transcriptome analysis of tyrosine kinase inhibitors (TKI)-resistant clones provides the insights into the mechanism of drug resistance, which can facilitate the development of an effective screening method as well as therapeutic intervention to deal with TKI resistance.

Comparison of the effect-site concentrations of remifentanil for Streamlined Liner of the Pharynx Airway (SLIPA) versus laryngeal mask airway SoftSealTM insertion during target-controlled infusion of propofol

This study was designed to determine the optimal dose of remifentanil required for the successful insertion of Streamlined Liner of the Pharynx Airway (SLIPA) and to compare it to that required for laryngeal mask airway (LMA) insertion in patients receiving a propofol infusion at a standard effect-site concentration. Fifty-eight patients scheduled to undergo general anaesthesia were randomly assigned to either the SLIPA (n = 29) or LMA (n = 29) group. All patients were premedicated with midazolam 0.05 mg x kg(-1) and glycopyrrolate 0.004 mg x kg(-1) intramuscularly. After the administration of lignocaine 1 mg x kg(-1) intravenously, a propofol infusion was started at an effect-site concentration of 3.5 microg x ml(-1) with a remifentanil infusion without a neuromuscular blocking agent. The remifentanil dose was determined by the modified up-and-down method starting in each group at 4 ng x ml(-1). Six minutes after induction, the airway device was inserted. Airway device insertion was classified as 'success' or 'failure' based on patient response. From the isotonic regression analysis and bootstrap distribution, the EC50 of remifentanil for SLIPA and LMA were 0.93 ng x ml(-1) (95% confidence interval [CI] 0.81 to 1.50 ng x ml(-1) and 1.36 ng x ml(-1) (95% CI 1.19 to 2.06 ng x ml(-1)) respectively, and the EC95 for SLIPA and LMA insertions were 1.90 ng x ml(-1) (95% CI 1.39 to 1.95) and 2.43 ng x ml(-1) (95% CI 1.80 to 2.46 ng x ml(-1)) respectively. Using the 83% CIs from the bootstrap distribution, EC50 for SLIPA was significantly less than that of LMA (0.83 to 1.23 vs 1.26 to 2.00, respectively) (P < 0.05). These findings suggest that the insertion of SLIPA needs about a 32% lower depth of anaesthesia than LMA insertion.

Anatomo-radiological evaluation of lateral approaches to the skull base

Our objective is to correlate the anatomical exposure provided by complex skull base approaches to the lateral skull base with their CT and MRI scans counterparts and to introduce a modular concept emphasizing the derivation of complex skull base approaches from simpler ones.We executed 10 lateral approaches to the skull base in 20 embalmed cadaveric heads (40 sides). Each approach was executed a minimum of three times on each specimen. These approaches were the pterional and its modifications, the subtemporal and its modifications, and the suboccipital and its modifications. We correlated the approaches and the areas of the skull base exposed by scanning the surgical cavity filled with material imageable by CT and MRI and throughly surveying the operative field.Visualization of the area of the skull base exposed was excellent using our CT-MRI imageable cadaveric preparation. The topographic areas of the skull base exposed correlated well with their radiological counterparts.The areas of the skull base exposed by each of the complex surgical approaches to the skull base were clearly delineated by using our anatomo-radiological correlation. Complex approaches to the skull base are formed by simple neurosurgical approaches (building blocks) to which different modules are added.

Comprehensive review on herbal medicine for energy intake suppression

The obesity drug development is present not a bright and successful story. So far, drugs reported to be effective, either from synthetic or natural sources, mostly stimulated controversy because of serious adverse effects, which ended with stopping clinical trials or even withdrawal from the market. However, obesity and its comorbidities have become rapidly a major problem in both developed and developing countries. This has encouraged pharmaceutical companies and academia to keep on struggling on developing novel effective but safe obesity drugs, and on characterizing novel obesity drug targets. From existing scientific work on obesity drug discovery and commercial slimming preparations, compounds originating from nature, especially from plants, seem to be the first choice. Traditional belief that herbal medicine is safer than synthetic ones is one of the classical arguments, although scientifically this is not always true (e.g. ban on Ephedra). But in general, it has been widely acknowledged that a plant compound, with its unique scaffolds and rich diversity is an unlimited source of novel lead compounds. This paper aims to summarize all works focused on screening plant materials by targeting important pathways related to energy intake regulation, either by in vivo or in vitro experiments.

Prediction of acute pulmonary complications after resection of lung cancer in patients with preexisting interstitial lung disease

INTRODUCTION

Interstitial lung disease (ILD) is associated with a high morbidity from acute pulmonary complications, such as acute lung injury (ALI) or acute respiratory distress syndrome (ARDS), after pulmonary resection. This study attempts to uncover the risk factors for postoperative ALI/ARDS in lung cancer patients with ILD.

MATERIALS AND METHODS

We retrospectively reviewed 100 patients with ILD who underwent curative lung resection for lung cancer, from January 2000 to December 2008.

RESULTS

Of the 100 patients, 91 were male, and 9 were female. The median age was 66 years. Fifty-eight patients underwent a preoperative carbon monoxide diffusing capacity test (DLCo). Twelve pneumonectomies and 88 lobectomies were performed. Acute pulmonary complications were observed in 28 patients (13 with ALI and 15 with ARDS). Operative mortality was 14%. Cause of death was due to respiratory failure from ALI/ARDS in all patients, except in one patient who died due to complications of acute renal failure. For all 100 patients, univariate analysis revealed that preexisting comorbidities, such as ischemic heart disease, renal failure, COPD, and neoadjuvant treatment for lung cancer, were risk factors for the development of postoperative ALI/ARDS. For the 58 patients who underwent preoperative DLCo testing, significant univariate risk factors included preexisting comorbidities and decreased DLCo. Multivariate analysis did not show any significant risk factors for ALI/ARDS.

CONCLUSIONS

Preexisting comorbidities and decreased preoperative DLCo were the most significant risk factors for the development of acute pulmonary complications after pulmonary resection in patients with lung cancer and ILD.

Patterning of catalysts for the selective growth of carbon nanotubes using laser irradiation of nickel nitrate

We developed a simple method to produce patterned catalysts for the growth of carbon nanotubes (CNTs) on Si substrate using laser irradiation of Ni nitrate. We found that Ni nitrate can easily be decomposed into Ni oxide by KrF laser irradiation and that unexposed Ni nitrate can be removed using deionized (DI) water. Once we obtained patterned Ni oxide, we were able to synthesize multi-walled CNTs using a conventional thermal CVD. This new method does not require any photoresist or vacuum processes. Not only is the method compatible with low-temperature and large-area fabrication, it also significantly reduces the total processing steps required for conventional lithographic patterning technology. A detailed investigation of the decomposition process of this patterned catalyst and the microstructure of the patterned multi-walled CNTs was carried out using IR, SEM and TEM.

The association between serum thyrotropin (TSH) levels and bone mineral density in healthy euthyroid men

OBJECTIVE

Although osteoporosis is increasingly shown to occur in a considerable proportion of men, data on risk factors for male osteoporosis are limited. In this study, we investigated the association between serum thyrotropin (TSH) concentration and bone mineral density (BMD) in healthy euthyroid men. Design A cross-sectional community (health promotion centre)-based survey.

SUBJECTS AND MEASUREMENTS

For 1478 apparently healthy euthyroid men who participated in a routine health screening examination, we measured BMD at the lumbar spine and femoral neck using dual energy X-ray absorptiometry and serum TSH concentrations using immunoluminometry.

RESULTS

Lumbar spine BMD linearly increased with TSH level after adjustment for age, weight and height (P for trend = 0.002), and statistical significance persisted after additional adjustment for smoking and drinking habits (P for trend = 0.010). When serum alkaline phosphatase was added as a confounding variable, the relationship was still significant (P for trend = 0.016). Femoral neck BMD also tended to increase in higher TSH concentration after adjustment for age, weight and height (P for trend = 0.042), but this association disappeared after additional adjustment for smoking and drinking habits. The odds of lower BMD (i.e. osteopaenia and osteoporosis combined) were significantly increased in subjects with low-normal TSH (i.e. 0.4-1.2 mU/l), when compared to high-normal TSH (i.e. 3.1-5.0 mU/l), after adjustment for confounding factors (odds ratio = 1.45, 95% CI = 1.02-2.10).

CONCLUSION

These results suggest that a serum TSH concentration at the lower end of the reference range may be associated with low BMD in men.

Needlescopy-assisted resection of pulmonary nodule after dual localisation

The aim of this study was to evaluate the feasibility of dual localisation with hookwire and lipiodol before needlescopy-assisted resection for pulmonary nodule. Computed tomography-guided dual marking was performed on 36 pulmonary nodules of 32 patients and needlescopy-assisted resection was performed monitored by C-arm fluoroscopy. The mean age of the patients was 58 ± 12 (range 12-77) yrs. The mean size of the nodules was 7.5 ± 3.7 (3-17) mm. Their mean distance from the pleural surface was 7.3 ± 7.5 (0-35) mm. There were nine pure ground-glass opacity lesions, five semi-solid lesions and 22 solid lesions. The time of the dual localisation procedure was 13.1 ± 4.8 (7-23) min. Complications of the marking were pneumothorax in nine patients, and intrapulmonary bleeding in three. One hookwire dislodged during the operation. All nodules were successfully resected under needlescopy without conversion to a conventional thoracoscopy (5 mm or 10 mm thoracoscopy) or a minithoracotomy. There was no complication related to needlescopy-assisted resection. Dual marking with hookwire and lipiodol is a safe and none time consuming procedure, and needlescopy-assisted lung resection for small nodules is technically feasible and useful for histological diagnosis and treatment.

Efficient transfer of reporter gene-loaded nanoparticles to bone marrow stromal cells (D1) by reverse transfection

Nucleic acids can be complexed with cationic polymer to form DNA nanoparticles (polyplex) which are then immobilized on the surface coated extracellular matrix protein (ECM), the process termed as reverse transfection. ECM-containing proteins provide a surface for cell attachment and sustain the release of polyplexes from their surface, thereby inducing transgene expression for prolonged period of time. Consequently, long-term expression of the desired protein can be achieved with the smaller amount of required DNA, as compared to bolus delivery. First of all, we investigated the different ECM components as a coating material and the range of optimal coating density in different ECM was examined for enhanced transfection to neighboring cells. Reporter genes such as luciferase (luc) and enhanced green fluorescent protein (eGFP) were initially used to quantitate transfection efficiencies from polyplex from the coated ECMs of Collagen type I (Col I), fetal bovine serum protein (FBS), bovine serum albumin (BSA). DNA was complexed with positively charged polyethyleneimine (PEI) at N/P ratio 9. Our initial work exhibited that, in the case of both NIH/3T3 cell line and bone marrow stromal (D1) cell line, Col I facilitated the greatest cell adhesion compared to the other coating proteins and 0.5 microg/cm2 of Col I coating density resulted in highest transfection efficiency. On the other hand, comparison of reverse delivery system with atelocollagen-I have shown that reverse delivery system to yield ten times higher transfection efficiency than atelocollagen-PEI/DNA delivery system and one hundred times higher than atelocollagen-naked plasmid delivery system. Moreover, the amount of DNA used for reverse delivery system was much lower than the other systems. This methodology would be applied to induce cellular differentiation in 3-dimensional scaffold after coating scaffolds with genes inducing the differentiation in the nanoparticle formulation. Our final goal is to search for the optimal conditions for the differentiation of stem cells to specific cell types.

Utilization of power plant bottom ash as aggregates in fiber-reinforced cellular concrete

Recently, millions tons of bottom ash wastes from thermoelectric power plants have been disposed of in landfills and coastal areas, regardless of its recycling possibility in construction fields. Fiber-reinforced cellular concrete (FRCC) of low density and of high strength may be attainable through the addition of bottom ash due to its relatively high strength. This paper focuses on evaluating the feasibility of utilizing bottom ash of thermoelectric power plant wastes as aggregates in FRCC. The flow characteristics of cement mortar with bottom ash aggregates and the effect of aggregate type and size on concrete density and compressive strength were investigated. In addition, the effects of adding steel and polypropylene fibers for improving the strength of concrete were also investigated. The results from this study suggest that bottom ash can be applied as a construction material which may not only improve the compressive strength of FRCC significantly but also reduce problems related to bottom ash waste.

Outcomes after repeated resection for recurrent pulmonary metastases from colorectal cancer

BACKGROUND

It remains controversial whether metastasectomy is still feasible in patients with pulmonary recurrence from colorectal cancer, after initial metastasectomy. The aim of this study was to evaluate outcomes of repeated metastasectomy in these patients.

MATERIALS AND METHODS

From 1995 to 2007, 202 patients had received a pulmonary metastasectomy from colorectal cancer at our institution. Over a median follow-up of 28.9 months, 48 patients received second metastasectomy (29 wedge resections, 5 segmentectomies, 13 lobectomies, and 1 completion pneumonectomy). The median disease-free interval was 9.6 months. Among these 48 patients, 28 showed pulmonary recurrence again and of those, 10 patients received third metastasectomy (two wedge resections, two segmentectomies, four lobectomies, and two completion pneumonectomies).

RESULTS

There was no postoperative mortality. Of the 48 patients who underwent second metastasectomy, overall and disease-free 5-year survivals were 79% and 49%, respectively, after second operation. Of the 10 patients who received third metastasectomy, overall survival was 78% at 5 years after last operation.

CONCLUSIONS

Repeated resection after initial metastasectomy can be carried out safely and provides long-term survival in patients with recurrent pulmonary metastasis from colorectal cancer. Our findings indicate that close follow-up for the early detection of recurrence and parenchyma-saving resection can improve the results after repeated resection.

Capillary electrophoresis-assisted identification of peroxyl radical generated by single-walled carbon nanotubes in a cell-free system

The mechanism of how single-walled carbon nanotubes (SWCNTs) induce oxidative stress in cells has always been under debate. In the present paper, we have clearly identified the generation of peroxyl radical (ROO(*)) by the unmodified SWCNT and the poly(ethylene glycol)-functionalized SWCNT (SWCNT-PEG) in aqueous solutions using a simple analytical technique: capillary electrophoresis (CE). CE provides a sensitive detection platform for the oxidation product of the employed reactive oxygen species (ROS) indicator, 2,7-dichlorodihydrofluorescein (H(2)DCF). In addition, its high separation power eliminates the fluorescence quenching exerted by SWCNTs, which was a big problem that has been encountered in measurements with microplate readers, and facilitates the screening of a large variety of ROS scavengers, including small molecules, surfactant, and proteins, in our study. Furthermore, CE enables the simultaneous incubation of multiple ROS indicators for comparison of their oxidation efficiency, improving the detection specificity. The adsorption of oxygen on the SWCNT surface could be the source of the identified ROO(*), because surface coverage by surfactant or proteins could inhibit the oxidation and the anaerobic experiment led to data agreeing with the Langmuir isotherm. The peroxyl radical can serve as the seed for the production of more-active ROS after the SWCNT enters the cell and, therefore, SWCNTs hold potential toxicity to the biological hosts.

A multicenter phase II study of belotecan, new camptothecin analogue, in patients with previously untreated extensive stage disease small cell lung cancer

Belotecan (Camtobell, CKD602) is a new camptothecin derivative antitumor agent that belongs to the topoisomerase inhibitors. The aim of this phase II study was to evaluate the efficacy and safety of single agent belotecan in patients with small cell lung cancer (SCLC). Patients with previously untreated extensive stage disease (ED) SCLC were entered into the study. Belotecan was given by daily intravenous infusion at 0.5mg/m(2)/day for 5 consecutive days, every 3 weeks. 62 patients were enrolled in this study. The overall response rate to chemotherapy on an intention-to-treat basis was 53.2%. The median overall survival was 10.4 months, the median time to progression 4.6 months, and the 1-year survival rate 49.9%. The most common toxicity was hematologic. Grade 3/4 neutropenia occurred in 71.0% of patients and grade 3/4 thrombocytopenia 12.9%. Non-hematologic toxicity of grade 3 or 4 was low. The results suggest that belotecan is relatively active and well tolerable as single agent in patients with ED SCLC. Further investigations with platinum or other active agents are needed.