The most important point of the translational research for oncology is clinical application. The excellent research will clarify the molecular pathogenesis of cancer and develop a beneficial intervention in the clinic. The laboratory science done on patient material is a critical part of the translational research. However, there are several problems to expand the translational research in Japan. Developing excellent basic researches and arranging systems to support the translational research will be necessary.

The number of cancer patients and families desiring home-based care and out-patient chemotherapy has been increasing. Hence, a support system for home-based care is urgently needed for a patient with recurrent and/or advanced unresectable cancer who recieved cancer chemotherapy. The cancer therapy especially in patients with colorectal cancer could have expected an improvement of the prognosis utilizing FOLFOX/FOLFIRI, a standard therapy established in Europe and America. Thereby, it was well recognized that the department of out-patient chemotherapy is very important for continuous venous infusion using a central venous port. Since May 2005, we started an out-patient department for patients receiving cancer chemotherapy and a risk management in order to establish a patient care team. The important thing we should recognize about the out-patient treatment is that there are many cases of cancer patients who are in the state of poor nourishment caused by plural factors such as protein-calorie malnutrition (PCM) by an intake disturbance, and the poor absorption in glucose, protein and fat which are necessary for a good metabolism. The poor nutritional status causes a deterioration of immune function and complications such as infectious diseases. Thereby, a good management of nourishment to the patient who received cancer chemotherapy is an important supportive therapy. It appears that a good management of nourishment prevented and/or alleviated the complication that caused by the treatment of cancer chemotherapy. Because of the out-patient treatment is to treat a patient in a short period of time without thorough evaluation about the same for in hospitalized patient, a team medical support, a prudent policy of chemotherapy by the medical team members consisting of nurses, pharmacists, dietitian, chemotherapist and the self-care guidance of the patient are strongly required.

Although amrubicin hydrochloride (AMR) has promising activity against pretreated lung cancer, there are few reports on the adverse events of this agent in a clinical practice setting. We analyzed the adverse events experienced in 27 hospitalized patients who had received AMR monotherapy by collecting data from the pharmaceutical management records. Neutropenia was the main hematological toxicity, and 77.8% of patients developed grade 3/4 neutropenia. Neutrophil counts reached the nadir in 9 to 21 (median 14) days and recovered to normal in 14 to 27 (median 20) days. Seven cases experienced febrile neutropenia without any serious sequelae. Grade 2 or worse non-hematological toxicities were fatigue, constipation, nausea, vomiting, anorexia, and pneumonitis. In comparison with the data of pre-marketing clinical trials, constipation was more commonly observed, while nausea/vomiting was less frequent probably due to appropriate preventive antiemetics. Based on these findings, we have created a novel drug information chart for patients and utilized it in pharmaceutical care in our hospital.

Recently it is considered that there is a small population of cells with stem cell property not only in leukemia but also in solid cancer.These cells show the ability of self-renewal and multi-potential differentiation, and can initiate and maintain a tumor. The origin of cancer stem cells might be their normal stem cells, progenitor cells, or bone marrow-derived cells. It is still difficult to isolate cancer stem cells in solid cancer. There are three possible methodologies to isolate or identify cancer stem cells; the use of a surface marker, use of cells cultured in a specific condition (sphere), or the use of side population cells identified by FACS. The gold standard assay that fulfills the definition of cancer stem cell may be serial transplantation in animal models. Cancer stem cells are likely to be responsible for disease relapse or metastasis, and also for resistance to radiation or conventional chemotherapy. The stem cell niche plays an important role on maintaining cancer stem cells. The novel promising therapies against cancer stem cells are considered, including antibody-based therapy, signal inhibitors, overcoming radiation and drug resistance, or differentiation therapy. Another interesting therapy targeting the niche may also be considered.