泌尿器癌に対するgemcitabine, nedaplatin併用療法（GN療法）

A pilot study of combination chemotherapy of gemcitabine and nedaplatin for urological cancer

　対象は尿路上皮癌（UC）9例，尿管扁平上皮癌（SCC）2例，腎集合管癌（CDC）1例である。UC全例と1例のSCCはセカンドラインとして，他の2例は導入化学療法として施行した。レジメンはgemcitabine 1,000mg/m²：Day 1，8，nedaplatin 80mg/m²：Day 1である。近接効果はPR 5例，SD 7例で，奏効率は42％であった。UC症例では奏効率22％で，SCCとCDC症例では奏効率100％であった。主な有害事象は骨髄抑制であった。GN療法はUC症例に対するセカンドライン化学療法としては満足のいく結果が得られなかったが，SCCとCDC症例に対しては有用である可能性が示唆された。

　We investigated the feasibility, safety, and anti-tumor activity of combination chemotherapy with gemcitabine and nedaplatin（GN therapy）in patients with urological cancer. A total of 12 patients were enrolled in the current study. Histological characteristics in this study were 9 patients of urothelial carcinoma（UC）, 2 patients of squamous cell carcinoma of the ureter（SCC）, and 1 patient of renal collecting-duct carcinoma（CDC）. All UC and one SCC were treated with GN therapy as second line chemotherapy. Other 2 patients were treated as induction chemotherapy. Systematic combination chemotherapy consisting of gemcitabine（1,000mg/m² on day 1 and 8）and nedaplatin（80mg/m² on day 1）was performed. 5 partial responses and 7 stable diseases were achieved in 12 assessable patients and corresponded to an over all response rate of 42％. 2（22％）of 9 patients of UC, all patients of SCC and CDC responded to GN therapy. Grade 3 and 4 toxicity was primarily hematologic. The result of current study suggests that GN therapy may be an effective treatment for patients with SCC and CDC. On the other hand, UC as second line chemotherapy was not successful.

（Rinsho Hinyokika 61：903-908, 2007）