Abstract
AIM
To evaluate the therapeutic effect of oxaliplatin on human gastric carcinoma and to explore the mechanisms.
METHODS
22 cases of stage IV gastric carcinoma patients received 4-6 (mean 4.6) cycles of first line combined chemotherapy with oxaliplatin (oxaliplatin 85 mg/m2, ivgtt, 1 h, d 1; leukovorin 200 mg/m2, iv, gtt, 1 h, d 1-5; 5-FU 300 mg/m2, iv, d 1-2; 5-FU, continuously iv, gtt, 48 h; 1 cycle/2w). Response rate, progression-free survival (PFS), total survival time, toxic side effects were evaluated. The inhibitory effect of oxaliplatin on human gastric cell line SGC-7901 was calculated by MTT and IC50 was measured. Flow cytometry and TUNEL were applied to evaluate the apoptosis of cell line induced by the drug. The expression of caspase-3 mRNA was detected by RT-PCR.
RESULTS
Total response (complete and partial) occurred in 9 (40.9%) patients. Mean PFS was 4.2 months and mean total survival time was 7.2 months. Cumulative neurotoxicity (all grade I-II), vomiting and diarrhea, myelosuppression appeared in 93.5%, 20%, 32.9% of the patients, respectively. Apoptosis index was elevated after incubating with 1 mmol/L oxaliplatin for 30 min, but without statistic significance (P>0.05), but was much higher both by flowcytometry and TUNEL with statistical significance (P<0.05) after incubating with 1 mmol/L oxaliplatin for 2 days. Caspase-3 mRNA expression was elevated in oxaliplatin treated cells and correlated with apoptosis induced by the drug.
CONCLUSION
Oxaliplatin is effective and well-tolerated on human advanced gastric carcinoma. Oxaliplatin could significantly inhibit the growth of human gastric cell line SGC-7901, inducing caspase-3 mRNA expression and cell apoptosis.
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