[SMANCS/lipiodol].

SMANCS is the first commercially available polymer conjugated drug invented by the author, in which the protein antitumor agent neocarzinostatin is conjugated with two short chains of poly(styrene-comaleic acid) half-butylate. It exhibits the highest tumor/blood ratio (> 1,000) when injected arterially as an oily formulation in Lipiodol (SMANCS/Lipiodol). In addition, SMANCS/Lipiodol can give very high tumor contrasting image under X-ray (e.g., CT-scan), and thus the optimal dosing regimen can be determined and offers a diagnostic advantage. Phase I/II study of SMANCS was initiated in 1989 and it was approved by the Japanese Government in the fall of 1993 for the treatment of hepatoma. Exploitation of its application for other tumors such as renal cell cancer and pleural/ascitic carcinomatosis is anticipated. The response rate of Grad IV Lipiodol retention is 48.5% at 4 months; and those of 6 and 12 months are 50% and 90%, respectively. The major side effect is fever, which is only transitory, and no bone-marrow suppression, renal or hepatic toxicity were observed.