WO2009096189A1 - 抗がん剤感受性判定マーカー - Google Patents
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- WO2009096189A1 WO2009096189A1 PCT/JP2009/000358 JP2009000358W WO2009096189A1 WO 2009096189 A1 WO2009096189 A1 WO 2009096189A1 JP 2009000358 W JP2009000358 W JP 2009000358W WO 2009096189 A1 WO2009096189 A1 WO 2009096189A1
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- anticancer agent
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- dimethylglycine
- phenylalanine
- cancer
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/47—Quinolines; Isoquinolines
- A61K31/4738—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems
- A61K31/4745—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems condensed with ring systems having nitrogen as a ring hetero atom, e.g. phenantrolines
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/15—Medicinal preparations ; Physical properties thereof, e.g. dissolubility
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- A—HUMAN NECESSITIES
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/5005—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells
- G01N33/5008—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells for testing or evaluating the effect of chemical or biological compounds, e.g. drugs, cosmetics
- G01N33/5011—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells for testing or evaluating the effect of chemical or biological compounds, e.g. drugs, cosmetics for testing antineoplastic activity
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- G—PHYSICS
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- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
- G01N33/6803—General methods of protein analysis not limited to specific proteins or families of proteins
- G01N33/6806—Determination of free amino acids
- G01N33/6812—Assays for specific amino acids
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2800/00—Detection or diagnosis of diseases
- G01N2800/52—Predicting or monitoring the response to treatment, e.g. for selection of therapy based on assay results in personalised medicine; Prognosis
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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- Y10S436/00—Chemistry: analytical and immunological testing
- Y10S436/811—Test for named disease, body condition or organ function
- Y10S436/813—Cancer
Definitions
- the present invention relates to an anticancer drug sensitivity determination marker used for determining whether or not a cancer of a subject patient has therapeutic reactivity to an anticancer drug, and its application.
- anticancer agents such as alkylating agents, platinum preparations, antimetabolites, anticancer antibiotics, and anticancer plant alkaloids. These anticancer agents may or may not be effective depending on the type of cancer. However, it is known that some types of cancer that are recognized as effective may or may not be effective depending on the individual patient. Whether or not an anticancer drug shows an effect on such individual patient's cancer is called anticancer drug sensitivity.
- CPT-11 Irinotecan hydrochloride
- CPT-11 is an anticancer agent developed in Japan and having an action mechanism of topoisomerase I inhibition.
- CPT-11 was approved in January 1994 as an effective drug for non-small cell lung cancer, small cell lung cancer, cervical cancer and ovarian cancer, and in July 1995, gastric cancer, colorectal cancer, breast cancer Indications for squamous cell carcinoma and malignant lymphoma are recognized.
- CPT-11 occupies the position of a global standard therapeutic drug as a first-line drug or second-line drug for multi-drug combination therapy particularly in the region of colorectal cancer, and its usefulness has been recognized (Non-patent Documents 1 to 6) .
- Chemotherapy for advanced and metastatic colorectal cancer is centered on key drugs such as CPT-11 and oxaliplatin, which appeared in the 1990s, and fluorouracil (5-FU), which has been a major treatment for colorectal cancer.
- the combined use with the fluorinated pyrimidine preparation dramatically improved clinical outcomes including survival.
- the response rate is still around 50%, and in the current situation, half of the patients who received anticancer drugs at the high risk of serious side effects have not been effective.
- the cancer chemotherapy treatment schedule is long-term, and after determining how many cool treatments have been performed while observing the occurrence of side effects, it is determined whether the effect has been obtained or whether the administration should be continued as is. Until then, it took a long time, expensive medical expenses, and side effects have occurred. Therefore, if there is a means for predicting whether or not an effect can be obtained for each patient at an early stage of treatment, the burden on the patient and the occurrence of side effects can be reduced, and medical costs can be reduced.
- CPT-11 itself has antitumor activity, it is activated by carboxyesterase in the body and has an antitumor activity that is approximately 100 to several thousand times stronger than CPT-11. 7-ethyl-10-hydroxycamptothecin (SN-38) ). It is considered that CPT-11 and SN-38 are present in the body at the same time to exhibit an antitumor effect.
- SN-38 is glucuronidated by UDP-glucuronosyltransferase (UGT) in hepatocytes and becomes non-cytotoxic SN-38 glucuronide conjugate (SN-38G), mainly in bile It is excreted and transferred to the intestinal tract, and then excreted in the stool.
- UDP-glucuronosyltransferase UDP-glucuronosyltransferase
- SN-38G non-cytotoxic SN-38 glucuronide conjugate
- a part of SN-38G excreted in the intestinal tract is deconjugated by ⁇ -glucuronidase contained in the intestinal bacterium to become active SN-38 again, and is reabsorbed via the intestinal epithelial transporter, and enterohepatic circulation, intestinal epithelium. It undergoes metabolism and excretion through steps such as glucuronidation by UGT in cells (Non-patent Document 7).
- SN-38 is thought to damage the intestinal mucosa and induce diarrhea. It also affects the bone marrow where cell division is active and has been shown to cause erythrocyte depletion, leukopenia and thrombocytopenia.
- Non-patent Document 10 plasma levels of Tissue inhibitor of metalloproteinase-1 (TIMP-1), which has anti-apoptotic effects, may be significantly correlated with the clinical prognosis of CPT-11 + 5-FU combination therapy for metastatic colorectal cancer Recently reported (Non-Patent Document 11).
- Tissue inhibitor of metalloproteinase-1 Tissue inhibitor of metalloproteinase-1
- An object of the present invention is to provide an anticancer drug sensitivity determination marker capable of discriminating treatment responsiveness of individual patients and a new cancer treatment means using the same.
- the present inventors comprehensively analyze the metabolome (total of all metabolites) in serum of in vivo tumor-bearing mice using a capillary electrophoresis-time-of-flight mass spectrometer (CE-TOFMS).
- CE-TOFMS capillary electrophoresis-time-of-flight mass spectrometer
- the concentration of a substance on a metabolic system involving L-phenylalanine and / or N, N-dimethylglycine in a biological sample derived from a cancer patient is measured, the cancer patient That it is possible to determine whether or not the cancer is sensitive to anticancer drugs, and that the suppression of the expression of this substance can be used as an index to enable screening for anticancer drug sensitivity enhancing agents.
- the present inventors have found that the therapeutic effect of the anticancer agent can be dramatically improved when the enhancer and the anticancer agent to be sensitized are used in combination, and the present invention has been completed.
- the present invention provides an anticancer drug sensitivity determination marker comprising a metabolic substance involving L-phenylalanine and / or N, N-dimethylglycine.
- the present invention also provides a method for determining sensitivity to an anticancer drug, comprising measuring a substance on a metabolic system involving L-phenylalanine and / or N, N-dimethylglycine in a sample. is there.
- the present invention also includes a method for determining sensitivity to an anticancer drug, comprising a protocol for measuring a substance on a metabolic system involving L-phenylalanine and / or N, N-dimethylglycine in a sample.
- a kit for carrying out the above is provided.
- the present invention provides a screening method for an anticancer drug sensitivity-enhancing agent using as an index the suppression of expression of a substance on a metabolic system involving L-phenylalanine and / or N, N-dimethylglycine. Furthermore, this invention provides the anticancer agent sensitivity enhancer obtained by said screening method. Furthermore, this invention provides the composition for cancer treatment which combines said anticancer agent sensitivity enhancer and the anticancer agent used as the object of sensitivity enhancement. Furthermore, the present invention provides use of a combination of the above anticancer drug sensitivity-enhancing agent and an anticancer agent targeted for sensitivity enhancement for the production of a therapeutic drug for cancer. Furthermore, the present invention provides a method for treating cancer, characterized by administering the anticancer agent sensitivity-enhancing agent described above and an anticancer agent that is an object of sensitivity enhancement.
- the anticancer drug sensitivity determination marker of the present invention Using the anticancer drug sensitivity determination marker of the present invention, the anticancer drug treatment reactivity of each patient can be accurately determined before anticancer drug administration or early after the start of anticancer drug administration, It is possible to select anti-cancer drugs with higher therapeutic effects, and as a result, it is possible to prevent the progression of cancer and the increase in side effects associated with continuous administration of anti-cancer drugs that cannot be expected to have therapeutic effects, and further reduce the burden on patients. Reduction of medical expenses can also be expected. In addition, if this marker is used, it is possible to screen for drugs that enhance the sensitivity of anticancer drugs, and the combined use of the targeted anticancer drugs and anticancer drug sensitivity-enhancing drugs will dramatically improve the effects of cancer treatment. Improve.
- Control group not transplanted with cancer cells (Cont), human cultured colon cancer cell HT-29 transplantation group (HT) with low SN-38 sensitivity, human culture colon cancer cell HCT-116 with SN-38 high sensitivity
- HT human cultured colon cancer cell
- HCT-116 with SN-38 high sensitivity
- One of the anti-cancer drug sensitivity determination markers in the present invention is a substance on the metabolic system involving L-phenylalanine (also referred to as L-phenylalanine metabolic substance).
- L-phenylalanine metabolic substance also referred to as L-phenylalanine metabolic substance.
- examples include all substances that increase the concentration of L-phenylalanine in the system, and substances that enhance metabolism to L-phenylalanine and substances that inhibit metabolism from L-phenylalanine.
- substances that enhance metabolism to L-phenylalanine include intermediates in the metabolic system from proteins and peptides to L-phenylalanine, enzymes involved in the metabolism, coenzymes, changes in the expression level and activity of the enzymes Substances to be included.
- substances that inhibit metabolism from L-phenylalanine include inhibitors of L-phenylalanine metabolizing enzymes, substances that reduce the expression level and activity of L-phenylalanine metabolizing enzymes, and coenzymes of L-phenylalanine metabolizing enzymes. . Of these, L-phenylalanine is particularly preferred.
- Another anticancer drug sensitivity determination marker in the present invention is a substance on the metabolic system involving N, N-dimethylglycine (also referred to as N, N-dimethylglycine metabolic substance).
- N, N-dimethylglycine also referred to as N, N-dimethylglycine metabolic substance.
- all substances that increase the concentration of N, N-dimethylglycine in the metabolic system are included. From substances that enhance metabolism to N, N-dimethylglycine, N, N-dimethylglycine Substances that inhibit the metabolism of.
- substances that promote metabolism to N, N-dimethylglycine include intermediates in the metabolic system from phospholipid to N, N-dimethylglycine, enzymes involved in the metabolism, coenzymes, and expression of the enzymes Substances that change the amount and activity are included.
- Substances that inhibit metabolism from N, N-dimethylglycine include inhibitors of N, N-dimethylglycine metabolizing enzymes, substances that reduce the expression level and activity of N, N-dimethylglycine metabolizing enzymes, and N, N -Co-enzymes for dimethylglycine metabolizing enzymes. Of these, N, N-dimethylglycine is particularly preferred.
- the serum concentration of L-phenylalanine and / or N, N-dimethylglycine was higher in mice transplanted with cancer cells than in the cancer cell non-transplanted group.
- HT-29 which is a SN-38 low-sensitivity cancer cell
- the concentration of L-phenylalanine and / or N, N-dimethylglycine did not decrease even after administration of CPT-11.
- HCT-116 a SN-38 highly sensitive cancer cell
- the concentration of L-phenylalanine and / or N, N-dimethylglycine decreased to the same level as in the control group by CPT-11 administration. did.
- L-phenylalanine and / or N, N-dimethylglycine is useful as a marker for determining sensitivity to anticancer agents such as CPT-11 and SN-38.
- the anticancer agent that is the target of the anticancer drug sensitivity determination marker of the present invention is not particularly limited as long as it is a cancer that affects the metabolic system of L-phenylalanine and / or N, N-dimethylglycine.
- L-phenylalanine and / or N, N-dimethylglycine metabolite in the sample may be measured.
- examples of the sample include biological samples derived from cancer subjects (cancer patients) such as blood, serum, plasma, urine, tumor tissue / cells, ascites, pleural effusion, cerebrospinal fluid, stool, sputum, and the like. Serum is particularly preferred.
- lip, oral and pharyngeal cancer typified by pharyngeal cancer
- digestive organ cancer typified by esophageal cancer
- stomach cancer colon / rectal cancer
- lung cancer Respiratory and intrathoracic organ cancer, bone and joint cartilage cancer, cutaneous malignant melanoma, squamous cell carcinoma and other skin cancers, mesothelioma and mesothelioma Tissue cancer, breast cancer, uterine cancer, female genital cancer represented by ovarian cancer, male genital cancer represented by prostate cancer, urinary tract cancer represented by bladder cancer, brain tumor Representative eye, brain and central nervous system cancer, thyroid and other endocrine adenocarcinoma, non-Hodgkin lymphoma and lymphoid leukemia, and other lymphoid tissue, hematopoietic tissue and related tissue cancer, and these as the primary focus Include metastatic tissue cancers, especially non-small cell lung cancer, small
- the means for measuring L-phenylalanine and N, N-dimethylglycine metabolizing substances in a sample may be appropriately determined depending on the substance to be measured.
- CE-TOFMS Gas chromatography-mass spectrometry (GC-MS), HPLC
- GC-MS Gas chromatography-mass spectrometry
- HPLC HPLC
- L-phenylalanine it can be quantitatively measured by CE-TOFMS, HPLC, biochemical measurement method, etc., and quantitative measurement by fluorescence intensity using an enzyme method is particularly easy.
- N, N-dimethylglycine it can be quantitatively measured by CE-TOFMS, HPLC, GC-MS or the like.
- L-phenylalanine and / or N, N-dimethylglycine metabolite concentration in a biological sample derived from a cancer patient before and after administration of the anticancer agent If the concentration of L-phenylalanine and / or N, N-dimethylglycine metabolizing substance does not change before and after administration of the anticancer drug, the cancer is not anticancer drug sensitive and anticancer drug administration If the concentration of L-phenylalanine and / or N, N-dimethylglycine metabolite after administration is lower than before, the cancer can be determined to be sensitive to an anticancer drug.
- the anticancer drug sensitivity determination marker in the present invention not only determines the anticancer drug treatment responsiveness, but also prevents an increase in side effects associated with continuous administration of an anticancer drug that cannot be expected to have a medicinal effect. Contribute greatly.
- kits including a protocol for measuring L-phenylalanine and / or N, N-dimethylglycine metabolite in a sample.
- the kit includes a reagent for measuring L-phenylalanine and / or N, N-dimethylglycine metabolite, a method for using the reagent, a standard for determining the presence or absence of anticancer drug sensitivity, and the like.
- the standard includes the standard concentration of L-phenylalanine and / or N, N-dimethylglycine metabolite, the concentration judged to be high, the concentration judged to be low, the factors affecting the measurement results and the extent of the influence These concentrations can be set for each target anticancer agent. Using the reference, it can be determined as described above.
- Anti-cancer drug sensitivity-enhancing agents can be screened using the suppression of the expression of L-phenylalanine and / or N, N-dimethylglycine metabolite as an index. That is, a substance that suppresses the expression of L-phenylalanine and / or N, N-dimethylglycine metabolic substance in vitro or in vivo enhances anticancer drug sensitivity. For example, a substance that enhances the decrease in the concentration of L-phenylalanine and / or N, N-dimethylglycine metabolic substance before and after administration of an anticancer drug in a cancer-bearing animal is a substance that enhances the sensitivity of the anticancer drug. (Anticancer agent sensitivity enhancer).
- anti-cancer agents can be screened using L-phenylalanine and / or N, N-dimethylglycine metabolite as an index. That is, if the concentration of L-phenylalanine and / or N, N-dimethylglycine metabolite is reduced by a certain substance in vitro or in vivo, the substance is an anticancer agent. For example, if the concentration of L-phenylalanine and / or N, N-dimethylglycine metabolite decreases after administration of a substance to a cancer-bearing animal, the substance is an anticancer agent.
- N-dimethylglycine metabolite In vitro, if a substance is exposed to various cancer cell lines and the concentration of L-phenylalanine and / or N, N-dimethylglycine metabolite is reduced compared to before exposure, the substance is resistant. It is a drug.
- an anticancer agent that can be expected to have a medicinal effect, a decrease in the concentration of L-phenylalanine and / or N, N-dimethylglycine metabolite appears earlier than the tumor shrinkage or cell killing effect, so L-phenylalanine and / or By screening using an N, N-dimethylglycine metabolite as an index, whether or not the substance is useful as an anticancer agent can be determined in a shorter time. A significant effect can be expected from the viewpoint of reducing labor and costs associated with the development of anticancer drugs.
- the combined form of the anticancer agent sensitivity-enhancing agent and the anticancer agent targeted for sensitivity enhancement may be a single composition containing both of these components. There may be. In addition, these components may be different administration routes.
- Anticancer agents to be used here are the same as those described above, and include CPT-11, SN-38, oxaliplatin, cyclophosphamide, ifosfamide, thiotepa, melamine.
- Example 1 (1) Method (a) Animals Ordinary baits that can be fed freely in a temperature-controlled room using nude mice (BALB / cAJcl-nu / nu), 6-week-old male mice purchased from CLEA Japan And gave drinking water. In this study, we applied for a protocol in accordance with the guidelines for animal experimentation at Keio University School of Medicine, and received it in a friendly manner.
- Camptosar TM and Camptosar dissolving agent is a preparation of a drug CPT-11 were obtained from Yakult Honsha Co., Ltd..
- tumor size was measured using a major axis ⁇ minor axis 2/2 wherein tumor size randomly assigned to a dissolving agent administration group CPT-11 administration group when it becomes 300-400mm 3, day0 and then, in the CPT-11 administration group, CPT-11 in a formulation Camptosar TM to 4.5 mL / kg (CPT-11 amount as 90 mg / kg), as the CPT-11 non-administration group, solubilizers camptothecin TM (D-sorbitol, lactic acid, pH regulator) was slowly administered from the tail vein. Day 0, 12 hours, 24 hours, 72 hours, and 7 days after administration, the tumor size was measured, and blood was collected after dissection.
- the collected blood was centrifuged at 10,000 rpm for 10 minutes, and then the serum fraction was frozen in liquid nitrogen and stored at ⁇ 80 ° C. until used for the preparation of metabolome samples.
- a cancer cell non-transplant group was also prepared as a control group and subjected to the same treatment.
- the human cultured colon cancer cell HCT-116 used in this study is more sensitive to CPT-11 than the human cultured colon cancer cell HT-29, and conversely, the human cultured colon cancer cell HT-29 is human. It was confirmed that the sensitivity to CPT-11 was lower than that of cultured colon cancer cell HCT-116.
- the average number of peaks detected per sample was 263.
- candidate peaks that could serve as biomarkers showing CPT-11 drug reactivity were obtained.
- the candidate peaks are the m / z 166.086 peak (Fig. 2) obtained by measuring serum metabolites 24 hours after administration of CPT-11 or lysing agent, and serum 12 hours after CPT-11 or lysing agent administration. It was a peak of m / z 104.070 measured for the metabolite (FIG. 3).
- the CPT-11 administration group and the dissolution agent administration group 24 hours after drug administration 24 hours after drug administration
- the expression level in serum was similar.
- the CPT-11 administration group is comparable to the control group to which no cancer cells have been transplanted. Until then, the peak expression level in serum decreased. Therefore, it could be divided into a CPT-11 ineffective group and a CPT-11 effective group, and was considered a marker showing drug reactivity.
- the CPT-11 administration group and the lysing agent administration group 12 hours after drug administration In, the expression level in serum was comparable.
- the CPT-11 administration group is comparable to the control group to which no cancer cells have been transplanted. Until then, the peak expression level in serum decreased. Therefore, it could be divided into a CPT-11 ineffective group and a CPT-11 effective group, and was considered a marker showing drug reactivity.
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Abstract
Description
進行性・転移大腸癌に対する化学療法は、1990年代に登場したCPT-11、オキサリプラチンなどのkey drugと、それまで大腸癌治療の中心的薬剤であったフルオロウラシル(5-FU)を中心とするフッ化ピリミジン製剤とを併用することにより、生存率をはじめとする臨床成績が劇的に改善された。しかしそれでもなお奏効率はおよそ50%程度であり、重篤な副作用という高リスクを冒して抗がん剤が投与された患者の半分では効果が得られていないのが現状であり、個々の治療反応性(レスポンダー・ノンレスポンダー)を判別する抗がん剤感受性予測マーカーの確立は急務である。
一般的に、がん化学療法の治療スケジュールは長期に渡り、副作用の発現を見ながら何クールか繰り返し治療を行った後で、効果が得られているか、そのまま投与を続けるべきか判断するが、それまでには長い時間と高額な医療費がかかり、副作用の発現も起こっているのが事実である。よって、個々の患者に対し、効果が得られるかどうかを治療早期に予測できる手段があれば、患者の負担や副作用の発現を軽減し、医療費を削減することができる。
重篤な下痢や好中球減少症などの副作用は、UGT1A1遺伝多型がもたらすSN-38体内曝露量の変化が一因であることが示されている。しかし治療効果に関しては、プロドラッグであるCPT-11から活性代謝物SN-38への変換とその解毒、さらに腸管循環の過程におけるSN-38の再生成や、CPT-11自体の代謝と代謝物からのSN-38の生成といった体内動態の複雑性により、薬物動態により治療効果を予測できるとする報告は未だなされていない。末梢血単核球細胞のカルボキシルエステラーゼmRNA発現量がSN-38とSN-38GのAUC比とは相関するものの腫瘍縮小効果とは相関がなかったとする報告もなされている(非特許文献8)。
また、本発明は、検体中のL-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質を測定することを特徴とする抗がん剤感受性の判定方法を提供するものである。
また、本発明は、検体中のL-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質を測定するためのプロトコールを含むことを特徴とする抗がん剤感受性の判定方法を実施するためのキットを提供するものである。
さらに本発明は、L-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質の発現抑制を指標とする抗がん剤感受性亢進剤のスクリーニング方法を提供するものである。
さらにまた本発明は、上記のスクリーニング方法により得られた抗がん剤感受性亢進剤を提供するものである。
さらに本発明は、上記の抗がん剤感受性亢進剤と、感受性亢進の対象となる抗がん剤とを組み合せてなるがん治療用組成物を提供するものである。
さらに本発明は、上記の抗がん剤感受性亢進剤と、感受性亢進の対象となる抗がん剤との組み合せの、がん治療薬製造のための使用を提供するものである。
さらに本発明は、上記の抗がん剤感受性亢進剤と、感受性亢進の対象となる抗がん剤とを投与することを特徴とするがん治療方法を提供するものである。
また、抗がん剤投与前あるいは投与後初期の段階において、L-フェニルアラニン及び/又はN,N-ジメチルグリシン代謝系物質の濃度が所定の標準濃度より高いと判断される濃度を有する場合は、そのがんは対象とする抗がん剤に対して感受性ではないと判定できる。対象とする抗がん剤に対して感受性を有さない場合は、その薬効を期待することができず、このような薬効の期待できない抗がん剤の投与が続けられた場合、がんの進行、副作用の増大が危惧される。このように、本発明における抗がん剤感受性判定マーカーは、抗がん剤治療反応性の判定のみならず、薬効の期待できない抗がん剤の継続投与に伴う副作用の増大を防ぐことにも大きく貢献する。
(1)方法
(a)動物
日本クレア社から購入したヌードマウス(BALB/cAJcl-nu/nu)、6週齢の雄性マウスを使用し、恒温室で自由に摂食可能な状態で通常の餌と飲水を与えた。本検討は慶應義塾大学医学部動物実験ガイドラインに沿ったプロトコルを申請し、承認を得て愛護的に行った。
(b)ヒト培養大腸癌細胞
SN-38高感受性であるヒト培養大腸癌細胞HCT-116とSN-38低感受性であるヒト培養大腸癌細胞HT-29は、株式会社ヤクルト本社より入手した。
(c)薬剤
CPT-11の製剤であるカンプトTMとカンプト溶解剤は、株式会社ヤクルト本社より入手した。
6週齢のヌードマウスの後背部に、SN-38低感受性であるヒト培養大腸癌細胞HT-29とSN-38高感受性であるヒト培養大腸癌細胞HCT-116を200万個/100μL/マウスで皮下移植した。移植後、腫瘍サイズを長径×短径2/2の式を用いて測定し、腫瘍サイズが300-400mm3となった時点でCPT-11投与群と溶解剤投与群に無作為に割り付け、day0とし、CPT-11投与群には、CPT-11の製剤であるカンプトTMを4.5mL/kg(CPT-11量として90mg/kg)、CPT-11非投与群としては、カンプトTMの溶解剤(D-ソルビトール、乳酸、pH調節剤)を尾静脈より、緩徐に投与した。day0、投与12時間後、24時間後、72時間後、7日後に腫瘍サイズを測定し、解剖後採血を行った。採取した血液は、10,000rpmにて10分間遠心分離後、血清画分を液体窒素にて凍結し、メタボローム用サンプルの調製に使用するまで-80℃で保存した。コントロール群として癌細胞非移植群も作製し、同様の処置を施した。
マウス解剖後-80℃で保存してある血清に、内部標準物質(IS)を添加したメタノール溶液を加え、タンパク質を変性させた後、クロロホルムとミリQ水を加え液―液抽出を行い、夾雑成分を除去した。代謝物を含む水―メタノール層を採取し、分画分子量5000kDaの遠心限外ろ過フィルターを用いて除タンパクを行った後、ろ液を減圧乾燥し、-80℃に保存した。測定直前にミリQ水に溶解させ、メタボローム測定に供した。
血清中代謝物の網羅的測定はAgilent Technologies社のキャピラリー電気泳動―飛行時間型質量分析計(CE-TOFMS)にて行った。本検討では、キャピラリーの出口が陰極となるように電圧を印加し、陽イオン性の代謝物を網羅的に測定した。
得られたピークは、ピーク自動抽出ソフトであるMolecular Feature Extratcor(Agilent technologies,Inc.)を用いて、m/z 50-1000、RT 0-50分、S/N比2以上の条件でピークを自動抽出させ、Microsoft excelTM上にて横軸にm/z、縦軸にピーク強度のIS ratioをプロットさせた。解析方法としては、Microsoft excelTM上に横軸m/zを細かくプロットし、一つずつピークの発現量の差を確認して行った。
ヌードマウスの後背部に、SN-38高感受性であるヒト培養大腸癌細胞HCT-116とSN-38低感受性であるヒト培養大腸癌細胞HT-29を移植した後、腫瘍サイズを、長径×短径2/2の式を用いて測定を行った。腫瘍サイズが300-400mm3となった時点でCPT-11投与群と溶解剤投与群に無作為に割り付け、day0と投与12時間後、24時間後、72時間後、及び7日後の腫瘍サイズを測定し、その結果を図1に示した。投与後7日後において、SN-38高感受性であるヒト培養大腸癌細胞HCT-116を移植し、CPT-11を投与した群と、溶解剤を投与した群において有意な差が認められた(p=0.01319)。また、SN-38高感受性であるヒト培養大腸癌細胞HCT-116を移植し、CPT-11を投与した群と、CPT-11低感受性であるヒト培養大腸癌細胞HT-29を移植し、CPT-11を投与した群においても有意な差が認められた(p=0.04979)。よって、本検討で使用したヒト培養大腸癌細胞HCT-116はヒト培養大腸癌細胞HT-29と比較して、CPT-11に対する感受性が高く、逆に、ヒト培養大腸癌細胞HT-29はヒト培養大腸癌細胞HCT-116と比較して、CPT-11に対する感受性が低いことを確認することができた。
Claims (30)
- L-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質からなる抗がん剤感受性判定マーカー。
- L-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質が、L-フェニルアラニン及び/又はN,N-ジメチルグリシンである請求項1記載の抗がん剤感受性判定マーカー。
- 抗がん剤が、植物アルカロイド系抗がん剤である請求項1又は2記載の抗がん剤感受性判定マーカー。
- 抗がん剤が、イリノテカン、SN-38及び/又はそれらの塩である請求項1又は2記載の抗がん剤感受性判定マーカー。
- 検体中のL-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質を測定することを特徴とする抗がん剤感受性の判定方法。
- L-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質が、L-フェニルアラニン及び/又はN,N-ジメチルグリシンである請求項5記載の判定方法。
- 検体が、がんを有する被験者由来の生体試料である請求項5又は6記載の判定方法。
- 検体が、抗がん剤を投与された、がんを有する被験者由来の生体試料である請求項5~7のいずれか1項記載の判定方法。
- 抗がん剤が、植物アルカロイド系抗がん剤である請求項5~8のいずれか1項記載の判定方法。
- 抗がん剤が、イリノテカン、SN-38及び/又はそれらの塩である請求項5~8のいずれか1項記載の判定方法。
- 検体中のL-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質を測定するためのプロトコールを含むことを特徴とする請求項5~10のいずれか1項記載の判定方法を実施するためのキット。
- L-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質が、L-フェニルアラニン及び/又はN,N-ジメチルグリシンである請求項11記載のキット。
- 検体が、がんを有する被験者由来の生体試料である請求項11又は12記載のキット。
- 検体が、抗がん剤を投与された、がんを有する被験者由来の生体試料である請求項11~13のいずれか1項記載のキット。
- 抗がん剤が、植物アルカロイド系抗がん剤である請求項11~14のいずれか1項記載のキット。
- 抗がん剤が、イリノテカン、SN-38及び/又はそれらの塩である請求項11~14のいずれか1項記載のキット。
- L-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質の発現抑制を指標とする抗がん剤感受性亢進剤のスクリーニング方法。
- L-フェニルアラニン及び/又はN,N-ジメチルグリシンが関与する代謝系上の物質が、L-フェニルアラニン及び/又はN,N-ジメチルグリシンである請求項17記載のスクリーニング方法。
- 抗がん剤が、植物アルカロイド系抗がん剤である請求項17又は18記載のスクリーニング方法。
- 抗がん剤が、イリノテカン、SN-38及び/又はそれらの塩である請求項17又は18記載のスクリーニング方法。
- 請求項17~20のいずれか1項記載の方法により得られた抗がん剤感受性亢進剤。
- 請求項21記載の抗がん剤感受性亢進剤と、感受性亢進の対象となる抗がん剤とを組み合せてなるがん治療用組成物。
- 抗がん剤が、植物アルカロイド系抗がん剤である請求項22記載のがん治療用組成物。
- 抗がん剤が、イリノテカン、SN-38及び/又はそれらの塩である請求項22記載のがん治療用組成物。
- 請求項21記載の抗がん剤感受性亢進剤と、感受性亢進の対象となる抗がん剤との組み合せの、がん治療薬製造のための使用。
- 抗がん剤が、植物アルカロイド系抗がん剤である請求項25記載の使用。
- 抗がん剤が、イリノテカン、SN-38及び/又はそれらの塩である請求項25記載の使用。
- 請求項21記載の抗がん剤感受性亢進剤と、感受性亢進の対象となる抗がん剤とを投与することを特徴とするがん治療方法。
- 抗がん剤が、植物アルカロイド系抗がん剤である請求項28記載の方法。
- 抗がん剤が、イリノテカン、SN-38及び/又はそれらの塩である請求項28記載の方法。
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JP2009551436A JP5461200B2 (ja) | 2008-01-31 | 2009-01-30 | 抗がん剤感受性判定マーカー |
AU2009208519A AU2009208519A1 (en) | 2008-01-31 | 2009-01-30 | Marker for determination of sensitivity to anti-cancer agent |
CN200980103934.5A CN101932939B (zh) | 2008-01-31 | 2009-01-30 | 抗癌剂感受性判定标记 |
CA2712966A CA2712966A1 (en) | 2008-01-31 | 2009-01-30 | Marker for determination of sensitivity to anti-cancer agent |
US12/865,725 US8945929B2 (en) | 2008-01-31 | 2009-01-30 | Marker for determination of sensitivity to anti-cancer agent |
EP09705658.4A EP2237042B1 (en) | 2008-01-31 | 2009-01-30 | Marker for determination of sensitivity to anti-cancer agent |
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CN (1) | CN101932939B (ja) |
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CA (1) | CA2712966A1 (ja) |
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SG192544A1 (en) | 2013-08-30 |
EP2237042A1 (en) | 2010-10-06 |
EP2237042A4 (en) | 2011-07-06 |
CN101932939A (zh) | 2010-12-29 |
EP2237042B1 (en) | 2014-03-12 |
US20110003842A1 (en) | 2011-01-06 |
CA2712966A1 (en) | 2009-08-06 |
CN101932939B (zh) | 2014-01-08 |
EP2698637B1 (en) | 2015-08-12 |
KR20110003464A (ko) | 2011-01-12 |
EP2698637A1 (en) | 2014-02-19 |
JPWO2009096189A1 (ja) | 2011-05-26 |
US8945929B2 (en) | 2015-02-03 |
AU2009208519A1 (en) | 2009-08-06 |
JP5461200B2 (ja) | 2014-04-02 |
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