ANGIOTENSIN-II (AII) INDUCED HYPERTENSION CHEMOTHERAPY (IHC) FOR UNRESECTABLE GASTRIC-CANCER - WITH REFERENCE TO RESECTION AFTER DOWN STAGING

Angiotensin II induced hypertension chemotherapy (MC) is a drug delive ry system for augmentation of anti-cancer effects on the experimental basis of the functional difference of microcirculation between tumor a nd normal tissue. Blood how in tumor tissue increased selectively when the blood pressure was elevated by the infusion of angiotensin II, Tw o randomized controlled trials (RCT) for advanced gastric cancer using AFM regimen; a combination of adriamycin (ADM), 5-fluorouracil (5-FU) , and mitomycin (MMC), showed increased response rate by IHC (response rate: IHC/non-IHC; 42.9% vs 10.5% in RCT-1, and 31.3% vs 6.7% in RCT- 2, respectively). Toxicities were not different statistically between groups, In phase II for stage IVB gastric cancer patients (the criteri a according to the General Rules of the Gastric Cancer Study of Japane se Research Society for Gastric Cancer), 5 complete response (CR) and 10 partial response (PR) (58%) were observed out of 26 unresectable ca ses without prior chemotherapy, Moreover, 5 of 15 responders could rec eive curative gastrectomy and obtained conclusive down staging (19%). Here we discuss the role of enhancement of drug delivery for cancer ch emotherapy on the basis of a series of clinical and experimental evide nces.