悪性脳腫瘍における薬剤耐性遺伝子解析に基づいた抗癌剤治療

Chemotherapy for Gliomas Based on the Expression Levels of Drug Resistant Genes

I．はじめに

　癌化学療法を行ううえで抗癌剤に対する耐性が大きな障害となっている．その作用機序の1つとしてmultidrug resistance（MDR）-1に代表されるエネルギー依存性薬剤排出ポンプによる多剤耐性があげられる^2）．今回，悪性脳腫瘍において，現在，報告されている7種類の薬剤耐性遺伝子の発現を検索し，その結果に基づき抗癌剤治療を行ったので報告する．

Drug resistance, which often occurs during chemotherapy,is still a great obstacle to the success of hu-man malignancy treatment. Among many possible mechanisms of drug resistance (biological, biochemical,kinetic or pharmacological), both typical and atypical multidrug-resistance (MDR) have been extensivelystudied. We picked up MDR-1, MXR, MRP1, MRP2, Topollα, MGMT, and GST-πas drug-resistant gene,based on experimental data and previous reports. Expression of these genes were measured in 14 malig-nant glioma specimens by reverse transcription polymerase chain reaction assay. We chose anticancerdrugs for each patient, based on results of drug resistant gene expression to acquire good response todrugs. Though our follow-up periods are not long enough to analyze the results of our chemotherapy, 78%(7/9) of our glioma patients who were treated with our chemotherapy are free from tumor progression.The assays, which measure the expression of drug resistant genes, are necessary to allow rapid detectionof the drug-sensitivity to chemotherapy in mahgnant glioma patients.