2023 Fiscal Year Final Research Report

Development of new synchronized chemotherapy by controlling exercise therapy stress and drug transporter expression vibration

Research Project

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Project/Area Number	21K08717
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 55020:Digestive surgery-related
Research Institution	Wakayama Medical University
Principal Investigator	Ken-ichi Okada 和歌山県立医科大学, 医学部, 講師 (50407988)
Co-Investigator(Kenkyū-buntansha)	山上裕機和歌山県立医科大学, 医学部, 学長特命教員(特別顧問) (20191190) 幸田剣和歌山県立医科大学, 医学部, 准教授 (20433352) 川井学和歌山県立医科大学, 医学部, 教授 (40398459) 廣野誠子兵庫医科大学, 医学部, 教授 (60468288)
Project Period (FY)	2021-04-01 – 2024-03-31
Keywords	運動ストレス
Outline of Final Research Achievements	This study is a prospective single-center phase II trial which aimed to examine whether a supervised exercise therapy for pancreatic ductal adenocarcinoma (PDAC) improved the completion rate of S-1 adjuvant chemotherapy . Forty-three patients were included in the study. The completion rate of S-1 therapy, the primary endpoint, was 93%, which exceeded the threshold completion rate of 53% (P <0.001). Regarding frailty status, there was significant decrease in the Kihon checklist score (P = 0.002) and significant increase in G8 questionnaire score (P < 0.001), indicating that exercise therapy reduced frailty. The differences between before/after therapy of mean muscle mass, mean body fat mass, and mean body fat percentage were 1.52 (P < 0.001), -1.18 (P = 0.007), and -2.47 (P < 0.001), respectively. Adjuvant chemotherapy combined with supervised exercise therapy for PDAC was confirmed to improve the completion rate of S-1 adjuvant chemotherapy.
Free Research Field	膵癌集学的治療
Academic Significance and Societal Importance of the Research Achievements	近年新規抗癌剤治療の導入・応用が進む中,既存治療もその効果を最大限に引き出すことが求められている.本研究は,能動的に担癌患者生体・腫瘍環境を変化させ,運動療法ストレスの抗腫瘍効果と化学療法を同期化させるという新しい発想に基づく.この方法により,術後高率に転移・再発を認める膵癌に対し,既存治療の効果を飛躍的に引き出そうとする斬新性があり,新規集学的治療が確立しうる.能動的に担癌患者の生体反応を変えて利用することで,難治癌の膵癌治療成績を革命的に変えるBreakthroughとなりえると考える.この新規療法が確立されれば、他臓器癌治療にも応用可能な,さきがけ治療となり得る.