Links M, Clingan P R, Phadke K, O'Baugh J, Legge J, Adams W J, Ross W B, Morris D L
UNSW Department of Surgery, St. George Hospital, Kogarah, Sydney, Australia.
Eur J Surg Oncol. 1995 Oct;21(5):523-5. doi: 10.1016/s0748-7983(95)97083-5.
Cimetidine has demonstrated a survival benefit in a randomized trial as adjuvant therapy for gastric cancer. We have demonstrated expression of histamine receptors on colon cancer cell lines and inhibition of their growth with cimetidine. Cimetidine also activates suppressor T cells and stimulates cell-mediated immunity. We therefore performed a randomized controlled clinical trial to determine the effect of cimetidine 400 mg given twice daily in conjunction with chemotherapy vs chemotherapy alone. Thirty-eight patients were randomized and 35 patients were eligible for further analysis. Both groups were well matched for pre-treatment characteristics. There was no difference in overall response. There was, however, a significantly increased rate of CEA response in the cimetidine group. Four of 11 patients (36%) in the cimetidine group had a CEA response compared to none of eight in the control. Meaningful comparisons of overall survival cannot yet be made. This study demonstrates that cimetidine has encouraging activity in increasing CEA response in patients with metastatic colorectal cancer treated with chemotherapy. This observation needs to be extended in a larger randomized study, which is currently underway.
在一项针对胃癌的随机试验中，西咪替丁作为辅助治疗已显示出生存获益。我们已证明组胺受体在结肠癌细胞系上的表达以及西咪替丁对其生长的抑制作用。西咪替丁还可激活抑制性T细胞并刺激细胞介导的免疫。因此，我们进行了一项随机对照临床试验，以确定每日两次给予400毫克西咪替丁联合化疗与单纯化疗相比的效果。38例患者被随机分组，35例患者符合进一步分析条件。两组在治疗前特征方面匹配良好。总体反应无差异。然而，西咪替丁组的癌胚抗原（CEA）反应率显著增加。西咪替丁组11例患者中有4例（36%）出现CEA反应，而对照组8例患者均无反应。目前尚无法对总生存期进行有意义的比较。本研究表明，西咪替丁在增加接受化疗的转移性结直肠癌患者的CEA反应方面具有令人鼓舞的活性。这一观察结果需要在一项正在进行的更大规模随机研究中进一步扩展。
