インタビュー
「Clinical Science Symposium：分子標的薬による消化器癌治療」の座長 Jean L. Grem氏に聞く
最終日の最後のセッションといえば，各国の参加者が早めの帰路につく影響で空席の目立つ会場も多くなるが，Clinical Science Symposium「分子標的薬による消化器癌治療」の会場は，最後のセッションにも関わらず聴講者で埋め尽くされていた。分子標的薬による治療はいずれの癌腫においても関心の的だが，なかでも近年は，消化器癌領域で注目度の高い発表が相次いでいる。わが国でも今年，これら欧米の臨床試験結果を受け，消化器癌領域で初めて分子標的薬が承認された。ここでは，分子標的も含めさまざまな消化器癌の臨床研究に携わり，米国国立癌研究所（NCI）では消化器癌部門主任を務めていたネブラスカ医科大学・Jean L. Grem氏に，消化器癌治療研究の最前線について話を聞いた。
| 編集部 | 先生は長年にわたり，NCIの消化器癌部門で治療薬や治療戦略開発に関する多くの研究に携わってこられましたが，現在の消化器癌治療では，特にどのような研究に注目されていますか？ |
| Grem氏 |  |
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molecular targeted agents：分子標的薬
CALGB：Cancer and Leukemia Group B（NCIが支援する癌と白血病の大規模臨床試験グループ）
FOLFOX，FOLFIRI：いずれも消化器癌に対する化学療法
Well, I think right now it seems like there’s a tendency to want to combine, you know, the molecular targeted agents, you know, the antibodies etc., with chemotherapy. And I think you know one of the important things will be to, you know, again look at not only overall impact on actual overall survival with that any of these strategies because of the expense of these regimens and everything. And so I think right now the ongoing trial that’s being done by CALGB is very important, which is looking at FOLFOX or FOLFIRI given with either bevacizumab, cetuximab or the combination. And I think that, you know, for some of these things I think we’re going to have to see a lot more, a much bigger effect to justify using these expensive regimens, you know, these biologics in combination.
| 編集部 | 近年，分子標的薬と化学療法との併用試験から有望な結果が相次いで報告され，消化器癌の治療成績は大きく向上していますが，今後の臨床研究の課題はどこにあるとお考えですか？ |
| Grem氏 | |
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clinical trial designs：臨床試験デザイン
target：ここでは分子標的薬
second line：二次治療
Well, I think right now, you know, it’s going to become, I think that the clinical trial designs are going to be a lot more complicated as the number of agents, you know, there are being incorporated as the results get better and better, it’ll be harder and harder to show incremental benefit with adding something new or new targets. So right now I think the challenge will be that we’re going to have to be doing probably larger and larger studies to be able to tell if we’re making an impact. And I think that right now a lot of the clinical studies aren’t really controlling for what people get second line, but that’s going to become very important since, you know, there are no strategies that allow people to be treated for several years.
