Clin Oncol | Volume 2, Issue 1 | Commentary | Open Access

Recent Molecular Immunological Chemotherapy for Gastrointestinal Malignancies

Masaya Mukai1*, Takayuki Tajima2, Sayuri Hasegawa1, Daiki Yokoyama1, Takuya Koike1, Shinichirou Hiraiwa3, Tomoko Sugiyama3 and Takuma Tajiri3

1Department of Digestive Surgery, Tokai University Hachioji Hospital, Japan
2Departmentof Digestive Surgery, Tokai University Oiso Hospital, Japan
3Department of Pathology, Tokai University Hachioji Hospital, Japan

*Correspondance to: Masaya Mukai 

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Efficacy of anticancer agents is generally dose-dependent and thus is determined by the Maximum Tolerated Dose (MTD) and Dose-Limiting Toxicities (DLT). Based on new theories such as the role of immune checkpoints in tumor cell survival, it seems important to investigate the optimum dosing method for antibody-drug conjugates that can have multimodal pharmacological actions, rather than inducing bone marrow suppression/immunosuppression at the MTD/DLT like traditional chemotherapy, allowing the cytotoxic anticancer agent to be administered at the Minimally Effective Cytotoxic Dose (MECD) that maintains host antitumor immunity together with cytotoxic activity. At present, both molecular-targeting agents and immune checkpoint inhibitors are available. As a future treatment strategy, we need to develop regimens that do not cause bone marrow suppression and do not require suspension or discontinuation of treatment due to toxicities. With such new regimens, cancer cells will be killed effectively while adverse reactions are reduced, so patients can enjoy improved high quality of life and longer progression-free survival. It is strongly anticipated that molecular-targeting therapy will be developed for gastrointestinal cancer, which will allow the total dose to be given safely at optimal schedules.


Molecular-targeting therapy; Minimally effective cytotoxic dose (MECD); Maximum tolerated dose (MTD); Dose-limiting toxicities (DLT); Immunosuppression


Mukai M, Tajima T, Hasegawa S, Yokoyama D, Koike T, Hiraiwa S, et al. Recent Molecular Immunological Chemotherapy for Gastrointestinal Malignancies. Clin Oncol. 2017; 2: 1233.

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