2000 Volume 8 Issue 1-2 Pages 155-167
There are no strategies to predict a patient's response to therapy. In a previous report, we classified Japanese patients into four groups according to the incidence of HLA antigens, by using quantification method III. In that study, we examined the patients' incidence of HLA antigens before surgery and evaluated their outcome according to the HLA classification by quantification method III. The aim of the present study is to evaluate whether HLA classification should be used in the treatment of individual cancer patients.
A consecutive series of 76 Japanese patients who had undergone gastrectomy between July 1998 and January 2000 was evaluated to compare the patients HLA classifications, derived from quantification method III, with their prognoses following gastrectomy.
Retrospective analysis of 193 gastric cancer patients revealed that HLA type I, type II, and type IV patients who had received postoperative adjuvant chemotherapy concomitant with PSK survived longer than those who had received postoperative adjuvant chemotherapy, whereas HLA type III patients who had received postoperative adjuvant chemotherapy showed significantly longer survival than those with chemotherapy+PSK. Following these results, we started a prospective study; we treated patients with HLA type I, type II, and type IV for postoperative chemotherapy+PSK, and those with HLA type III for postoperative chemotherapy following gastrectomy. The prospective study showed that patients who had been examined for HLA antigens showed significantly longer survival than those who had not been examined for HLA antigens.
From the results of our retrospective and prospective studies, it can be inferred that it is necessary to examine gastric cancer patients for HLA antigens, and that HLA-oriented therapy is a very promising strategy for cancer treatment. We are planning to conduct an important study with control subjects.
