RESUMEN
A 73-year-old man with advanced descending colon cancer and peritoneal metastases underwent a self-expandable metallic stent placement under fluoroscopic guidance on October 2007. The stent placement was successful without early complication. After 6 courses of FOLFOX4 followed by 7 courses of FOLFIRI, he received Bevacizumab-based chemotherapy from August 2008. In April 2009, he was admitted to our hospital with severe abdominal pain due to perforation of descending colon. Although emergent surgery was performed, he developed DIC and died on the 21 postoperative days. This case suggests that metallic stent placement for colorectal cancer cases might increase the risk of bowel perforation during Bevacizumab-based chemotherapy.
Asunto(s)
Inhibidores de la Angiogénesis/efectos adversos , Anticuerpos Monoclonales Humanizados/efectos adversos , Neoplasias del Colon/tratamiento farmacológico , Perforación Intestinal/inducido químicamente , Stents , Anciano , Inhibidores de la Angiogénesis/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Bevacizumab , Neoplasias del Colon/patología , Neoplasias del Colon/cirugía , Resultado Fatal , Humanos , Perforación Intestinal/cirugía , Masculino , Neoplasias Peritoneales/tratamiento farmacológico , Neoplasias Peritoneales/secundarioRESUMEN
Although the p53 anti-oncogene is an important target for gene therapy of cancer, some cancers are resistant to p53 gene transfer. For this reason, it is important to find effective drugs to enhance cytotoxic effects of p53 gene transfer. Recent reports demonstrated that some histone deacetylase inhibitors in combination with p53 gene therapy induced apoptosis in certain cancer cells more efficiently than p53 gene therapy alone. We investigated whether histone deacetylase inhibitor trichostatin A (TSA), in combination with p53 gene transfer could synergistically induce apoptosis in the breast cancer cell line MDA-MB-231. Whereas the adenovirus-expressing p53 (Ad-p53) by itself at up to 100 multiplicity of infection (MOI) induced apoptosis at a low level, Ad-p53 in combination with TSA synergistically induced apoptosis at a higher level in MDA-MB-231 cells than TSA or Ad-p53 alone. However, the combination of Ad-p53 and TSA did not enhance the expressions of p53 or p53-induced genes that are involved in apoptosis, and synergistically reduced the mitochondrial membrane potential and enhanced caspase-3 activity. These results suggest that TSA have synergistic effects on the induction of apoptosis in MDA-MB-231 cells when combined with p53 gene transfer.