先進的がん化学療法における薬剤師の役割

-再発悪性グリオーマ治療への貢献-

抄録

Malignant gliomas are common,aggressive brain tumors in adults and despite modern treatments with surgery,radiotherapy and chemotherapy,their prognosis remains dismal,with a poor median survival.The blood-brain barrier (BBB) restricts the delivery of many drugs to the central nervous system,contributing to the failure of treatment.Also,the effectiveness of traditional chemotherapy agents is limited by their adverse effects and their inability to cross the BBB in sufficient concentrations.
Recently developed agents,such as the oral alkylating agent temozolomide (TMZ),and irinotecan,a potent topoisomerase I inhibitor,have demonstrated efficacy against malignant gliomas and there are now new treatments that target molecules in the growth and survival pathways,whose goals are increasing specific efficacy and minimizing toxicity.Monoclonal antibodies and low molecular-weight kinase inhibitors are the most common types of agent in such targeted cancer treatment.Many molecular targeted agents,such as selective protein kinase inhibitors,are now in preclinical and clinical development for patients with malignant glioma.Oncology pharmacists have to contribute to the treatment of patients with malignant gliomas by taking part in such research and applying its results.They must also become highly skilled specialists in optimizing drug therapy for cancer patients through the design,recommendation,implementation,monitoring,and modification of individualized pharmacotherapeutic plans in collaboration with other members of healthcare teams.