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Japanese Journal of Clinical Oncology Advance Access published online on August 22, 2006

Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl082
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© 2006 Foundation for Promotion of Cancer Research
Received March 9, 2006
Accepted June 8, 2006

Original Article

Randomized Phase II Study of Immunomodulator Z-100 in Patients with Stage IIIB Cervical Cancer with Radiation Therapy

Kiichiro Noda 1, Yasuo Ohashi 2, Hiroji Okada 3, Sachio Ogita 4, Masami Ozaki 5, Yuzo Kikuchi 6, Yoshihiro Takegawa 7, Hideo Niibe 8, Shingo Fujii 9, Junichi Horiuchi 10, Kozo Morita 11, Shozo Hashimoto 12, and Keiichi Fujiwara 13 *

1 Kinki University, Japan
2 Department of Biostatistics/Epidemiology and Preventive Health Sciences, University of Tokyo, Tokyo, Japan
3 Saiseikai Suita Hospital, Suita, Osaka, Japan
4 Department of Obstetrics and Gynecology, Osaka City University, Osaka, Japan
5 Bell-land General Hospital, Sakai, Osaka, Japan
6 Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
7 Department of Radiologic Technology, Tokushima University School of Health Science, Tokushima, Japan
8 Department of Radiology and Radiation Oncology, Gunma University Hospital, Maebashi, Japan
9 Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan
10 Department of Radiology, Hakujikai Memorial Hospital, Tokyo, Japan
11 Toki Municipal Hospital, Toki, Gifu, Japan
12 Medical Scanning Shibuya, Tokyo, Japan
13 Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Okayama, Japan

* To whom correspondence should be addressed.
Keiichi Fujiwara, E-mail: fujiwara{at}med.kawasaki-m.ac.jp


   Abstract

Objective: To find the optimal dose of immunomodulator Z-100 in patients with stage IIIB squamous cell carcinoma of the cervix in combination with radiation therapy.

Methods: The patients were randomly assigned to the dosage levels of 2, 20 or 40 µg of Z-100. Z-100 was subcutaneously injected twice a week during radiotherapy and once in two weeks during the maintenance period. The response rate after radiotherapy was evaluated, and the optimal clinical dosage was then determined. Safety of Z-100 was evaluated during the radiation therapy and maintenance therapy. Survival was also evaluated.

Results: A total of 116 patients were entered. The adverse reactions were not dose-dependent and no serious toxicities were observed. The response rates were 72.2% (26/36) in the 2 µg group, 84.6% (33/39) in the 20 µg group and 94.3% (33/35) in the 40 µg group (P = 0.006). However, the survival was not significantly different.

Conclusions: The optimal dose of Z-100 was determined to be 40 µg in combination with radiation therapy for stage IIIB cervical cancer. However, impact of Z-100 on survival must be determined by the placebo controlled randomized trial, because survival benefit was not observed in this small population study.

Keywords: immunomodulator; cervical cancer; radiotherapy; Z-100; SSM.
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