Plachitin formed of both poly-
N-acetyl-D-glucosamine (
chitin) and
cis-diamminedichloroplatinum (CDDP), was used as an arterial chemoembolization
therapy against unresectable
liver cancer. One gram of
Plachitin contained 300 mg of CDDP. The
Plachitin particle was 50-100 microns in diameter.
Plachitin particles (50-100 mg) were injected via hepatic artery once or twice every week, and the total amount of 300 mg was considered one course of this
therapy. The size and number of
tumors were measured by computer tomography (CT). Pharmacokinetics of this
drug was also assessed by serum and urine
platinum (Pt) concentration. Three patients underwent the chemoembolization
therapy using
plachitin particles. Case 1 had multiple
hepatocellular carcinomas. The
tumor regression rate was 39% after two courses of this
therapy. Serum
alpha-fetoprotein (AFP) level decreased from 1,182 ng/ml to 300 ng/ml. Case 2 suffered from bile duct
cystadenocarcinoma. After three courses of the
therapy, the
tumor regression rate was 84.4%. Serum
carbohydrate antigen 19-9 (CA19-9) decreased from 731 U/ml to 75 U/ml. Case 3 had synchronous multiple liver
metastases from
sigmoid colon cancer. The
tumor regression rate was 77% after one course of the
therapy.
Carcinoembryonic antigen (CEA) and CA19-9 decreased from 406 ng/ml to 65 ng/ml and from 4,800 U/ml to 790 ng/ml, respectively. The response rate of the 3 cases was 66.7%. The peak levels of the serum Pt concentration of three patients were 0-0.4 microgram/g throughout the
therapy, but peak urine Pt concentrations were observed during one course of the
therapy of three patients ranging from 0.5 microgram/g to 3.2 micrograms/g, and decreased gradually for three weeks after the first course. Adverse effects of
Plachitin particles for arterial chemoembolization were epigastralgia,
nausea,
fever, and elevation of serum
aspartate aminotransferase (AST) and
alanine aminotransferase (ALT) levels. These adverse effects were observed in all patients, but were transient. Catheter obstruction occurred in one patient (case 2).
Cholecystitis,
pancreatic pseudocyst, and
duodenal ulcer were noticed in case 3. No renal hypofunction was observed.
Plachitin might be a useful agent for arterial chemoembolization
therapy for primary and secondary
liver cancer.