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Torasawa M, Shukuya T, Uemura K, Hayashi T, Ueno T, Kohsaka S, Masui Y, Shirai Y, Okura M, Asao T, Mitsuishi Y, Shimada N, Takahashi F, Takamochi K, Suzuki K, Takahashi K, Seyama K. Lymphangioleiomyomatosis as a potent lung cancer risk factor: Insights from a Japanese large cohort study. Respirology 2024. [PMID: 38654512 DOI: 10.1111/resp.14724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Lymphangioleiomyomatosis (LAM) is a rare neoplastic disease associated with the functional tumour suppressor genes TSC1 and TSC2 and causes structural destruction in the lungs, which could potentially increase the risk of lung cancer. However, this relationship remains unclear because of the rarity of the disease. METHODS We investigated the relative risk of developing lung cancer among patients diagnosed with LAM between 2001 and 2022 at a single high-volume centre in Japan, using data from the Japanese Cancer Registry as the reference population. Next-generation sequencing (NGS) was performed in cases where tumour samples were available. RESULTS Among 642 patients diagnosed with LAM (sporadic LAM, n = 557; tuberous sclerosis complex-LAM, n = 80; unclassified, n = 5), 13 (2.2%) were diagnosed with lung cancer during a median follow-up period of 5.13 years. All patients were female, 61.5% were never smokers, and the median age at lung cancer diagnosis was 53 years. Eight patients developed lung cancer after LAM diagnosis. The estimated incidence of lung cancer was 301.4 cases per 100,000 person-years, and the standardized incidence ratio was 13.6 (95% confidence interval, 6.2-21.0; p = 0.0008). Actionable genetic alterations were identified in 38.5% of the patients (EGFR: 3, ALK: 1 and ERBB2: 1). No findings suggested loss of TSC gene function in the two patients analysed by NGS. CONCLUSION Our study revealed that patients diagnosed with LAM had a significantly increased risk of lung cancer. Further research is warranted to clarify the carcinogenesis of lung cancer in patients with LAM.
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Affiliation(s)
- Masahiro Torasawa
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takehito Shukuya
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kohei Uemura
- Department of Biostatistics & Bioinformatics, Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Takuo Hayashi
- Department of Human Pathology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Toshihide Ueno
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Shinji Kohsaka
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Yoshihiro Masui
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yukina Shirai
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Makiko Okura
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tetsuhiko Asao
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoichiro Mitsuishi
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Naoko Shimada
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Fumiyuki Takahashi
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazuya Takamochi
- Department of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Kenji Suzuki
- Department of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Kazuhisa Takahashi
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kuniaki Seyama
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Fujita S, Nakano K, Nagasu A, Hiramatsu-Asano S, Akagi T, Morita Y. Prognosis and prognostic factors of lung cancer complications in patients with rheumatoid arthritis. Int J Rheum Dis 2024; 27:e15069. [PMID: 38514918 DOI: 10.1111/1756-185x.15069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 03/23/2024]
Abstract
AIM To clarify the prognosis and prognostic factors for lung cancer in patients with rheumatoid arthritis (RA). METHODS In this retrospective longitudinal study, we investigated the medical records of patients with RA among 1422 patients diagnosed with lung cancer and registered in a hospital-based cancer registry between January 2013 and May 2022. The Kaplan-Meier method and Cox proportional hazards model were used to analyze survival and identify predictive factors. RESULTS Of 26 patients with RA complicated with lung cancer (median age, 69 years), the 2-year overall survival rates for stages I-II were 90%-100%, and those for stages III-IV were 20%, respectively. Positivity of anti-citrullinated protein/peptide antibody, smoking history, interstitial lung disease, poorly controlled RA, stage III and IV lung cancer, histological types other than adenocarcinoma and squamous cell carcinoma, and RF ≧ 50 IU/mL were associated with increased mortality. After the surgical resection of stage I and II lung cancer, 5 of the 16 patients experienced cancer recurrence after resumption of RA treatment, and the histology of the recurrent cancers was mostly squamous cell carcinoma. CONCLUSIONS Early detection of lung cancer is needed, especially in patients with RA who have a history of smoking, seropositivity, or interstitial lung disease. Even after surgical resection, it should be noted that squamous cell carcinoma is prone to recurrence.
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MESH Headings
- Humans
- Aged
- Prognosis
- Lung Neoplasms/diagnosis
- Lung Neoplasms/epidemiology
- Lung Neoplasms/complications
- Retrospective Studies
- Longitudinal Studies
- Neoplasm Recurrence, Local/complications
- Arthritis, Rheumatoid/complications
- Arthritis, Rheumatoid/diagnosis
- Arthritis, Rheumatoid/epidemiology
- Lung Diseases, Interstitial/diagnosis
- Lung Diseases, Interstitial/epidemiology
- Lung Diseases, Interstitial/etiology
- Anti-Citrullinated Protein Antibodies
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/therapy
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Affiliation(s)
- Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Kazuhisa Nakano
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Akiko Nagasu
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | | | - Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
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3
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Hata A, Fifer S, Hasegawa K, Ando E, Kasahara‐Kiritani M, Takahashi M, Ordman R, Toh L, Inoue A. Treatment preferences among Japanese patients and physicians for epidermal growth factor receptor-mutant non-small cell lung cancer. Cancer Med 2024; 13:e6777. [PMID: 38196301 PMCID: PMC10807555 DOI: 10.1002/cam4.6777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/30/2023] [Accepted: 11/21/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION Evidence is limited on preferences of Japanese patients and physicians in treatment for epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). Several oral or intravenous novel agents for EGFR exon 20 insertions are under development. The aim of our study was to investigate which attributes of novel treatments influenced selection of oral or intravenous agents among treated patients and treating physicians in Japan. METHODS The study was designed by board-certified oncologists, patient representatives, and analytics specialists. Eligible participants completed an online survey with a discrete choice experiment presenting two treatment profiles described by attributes: mode of administration (oral or intravenous); frequency of administration; overall response rate (ORR); average progression-free survival (PFS); chance of experiencing severe side effects (SEs); mild-moderate gastrointestinal SEs; mild-moderate skin-related SEs; and patient out-of-pocket costs. RESULTS Fifty-four patients (all self-reported EGFR-mutant) and 74 physicians participated from December 2021 to August 2022. All attributes being equal, there was greater preference for oral administration. However, there was greater preference for intravenous over oral, when ORR and PFS improved by 10% and 1 month, and severe SEs reduced by 10%. Physicians exhibited greater preference for PFS compared to patients (p < 0.01). Ranked order of attribute importance was as follows: (1) PFS; (2) ORR; (3) severe SEs, expressed by patients and physicians alike. CONCLUSIONS Our study revealed Japanese physician and patient preferences in treatment options for EGFR-mutant NSCLC. Compared to the strong preference for a more efficacious drug, the preference of oral versus intravenous revealed a smaller impact.
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Affiliation(s)
- Akito Hata
- Division of Thoracic OncologyKobe Minimally Invasive Cancer CenterKobeHyogoJapan
| | - Simon Fifer
- Community and Patient Preference Research (CaPPRe)SydneyAustralia
| | - Kazuo Hasegawa
- NPO Lung Cancer Patients Association One StepKanagawaJapan
| | - Emiko Ando
- NPO Lung Cancer Patients Association One StepKanagawaJapan
| | | | | | - Robyn Ordman
- Community and Patient Preference Research (CaPPRe)SydneyAustralia
| | - Lili Toh
- Community and Patient Preference Research (CaPPRe)SydneyAustralia
| | - Akira Inoue
- Department of Palliative MedicineTohoku University School of MedicineSendaiMiyagiJapan
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Hino H, Hagihira S, Maru N, Utsumi T, Matsui H, Taniguchi Y, Saito T, Murakawa T. The surgical Apgar score predicts postoperative complications and the survival in lung cancer patients. Surg Today 2023; 53:1019-1027. [PMID: 36961607 DOI: 10.1007/s00595-023-02677-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/28/2022] [Indexed: 03/25/2023]
Abstract
PURPOSE The surgical Apgar score (SAS)-calculated using the intraoperative variables estimated blood loss, lowest heart rate, and lowest mean systolic pressure-is associated with mortality in cancer surgery. We investigated the utility of the SAS in patients with lung cancer undergoing surgery. METHODS We retrospectively analyzed the data of 691 patients who underwent surgery for primary lung cancer between 2015 and 2019 in a single institute and analyzed the impact of the SAS. RESULTS Of the 691 patients, 138 (20%), 57 (8.2%), and 7 (1.0%) had postoperative complications of all grades, grades ≥ III, and grade V, respectively, according to the Clavien-Dindo classification. The C-index for postoperative complications of grades ≥ III was 0.605. A lower score (0-5 points) (odds ratio 3.09 against 8-10 points, P = 0.04) and a lower percentage of vital capacity (odds ratio 0.97, P = 0.04) were independent negative risk factors for major postoperative complications. Patients with a lower score (0-5 points) had poor 5-year overall and cancer-specific survival rates (60.1% and 72.3%, respectively; P < 0.05 for both). CONCLUSIONS The surgical Apgar score predicted postoperative complications and the long-term survival. Surgeons may improve surgical results using the SAS.
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Affiliation(s)
- Haruaki Hino
- Department of Thoracic Surgery, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan.
| | - Satoshi Hagihira
- Department of Anesthesiology, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan
| | - Natsumi Maru
- Department of Thoracic Surgery, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan
| | - Takahiro Utsumi
- Department of Thoracic Surgery, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan
| | - Hiroshi Matsui
- Department of Thoracic Surgery, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan
| | - Yohei Taniguchi
- Department of Thoracic Surgery, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan
| | - Tomohito Saito
- Department of Thoracic Surgery, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan
| | - Tomohiro Murakawa
- Department of Thoracic Surgery, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan
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Guo M, Zhang E, Wang G, Ding R, Xu X, Fan P, Zheng Y, Xu D. Synthesis and in-vitro study of a novel ligustrazine diselenide as a potential chemotherapy drug for lung adenocarcinoma. Biomed Pharmacother 2023; 165:114699. [PMID: 37385210 DOI: 10.1016/j.biopha.2023.114699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 07/01/2023] Open
Abstract
A novel ligustrazine diselenide, 1,2-bis ((3,5,6-trimethylpyrazin-2-yl) methyl) diselenide (Se2), for potential treatment on adenocarcinoma of lung cancer was successfully synthesized and fully characterized by various analytical approaches. Cytotoxic, antiproliferative and apoptosis-triggering mechanism of Se2 compound have been investigated through human lung adenocarcinoma (LUAD) cell line A549. The study found that Se2 significantly inhibit the proliferation of A549 cells in a dose-dependent manner. Flow cytometry showed that Se2 induced cell arrest and apoptosis in S and G2/M phase, and the apoptotic effect of Se2 were associated with the increase of caspase 3 and PARP-1 level approved by western blot assay. Further mechanism study results suggested that Se2 suppressed the migration,invasion and colony formation of A549 cells, significantly inhibited the PI3K/Akt/m-TOR signaling pathway. The study indicated that Se2 is a bioactive substance that can induce apoptosis of A549 cells in-vitro, and it is a potent candidate drug for LUAD.
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Affiliation(s)
- Mudan Guo
- Chongqing Institute for Food and Drug Control, Chongqing 401121, China
| | - En Zhang
- Chongqing Institute for Food and Drug Control, Chongqing 401121, China
| | - Guiling Wang
- Chongqing Institute for Food and Drug Control, Chongqing 401121, China
| | - Rui Ding
- Chengdu Yukang Science and Technology Co. Ltd, Chengdu 610000, China
| | - Xiuying Xu
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China
| | - Pengjue Fan
- Chongqing Zhengbo Biotech Ltd., Chongqing 400714, China
| | - Yimin Zheng
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China
| | - Doudou Xu
- Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing 400045, China; Chongqing Institute for Food and Drug Control, Chongqing 401121, China.
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6
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Yamamoto H, Soh J, Okumura N, Suzuki H, Nakata M, Fujiwara T, Gemba K, Sano I, Fujinaga T, Kataoka M, Terazaki Y, Fujimoto N, Kataoka K, Kosaka S, Yamashita M, Inokawa H, Inoue M, Nakamura H, Yamashita Y, Hotta K, Yoshioka H, Morita S, Matsuo K, Sakamoto J, Date H, Toyooka S. Randomized phase II study of daily versus alternate-day administrations of S-1 for the elderly patients with completely resected pathological stage IA (tumor diameter > 2 cm)-IIIA of non-small cell lung cancer: Setouchi Lung Cancer Group Study 1201. PLoS One 2023; 18:e0285273. [PMID: 37205678 DOI: 10.1371/journal.pone.0285273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND It is shown that the postoperative adjuvant chemotherapy for non-small cell lung cancer (NSCLC) was associated with survival benefit in an elderly population. We aimed to analyze the feasibility and efficacy of alternate-day S-1, an oral fluoropyrimidine, for adjuvant chemotherapy in elderly patients with completely resected pathological stage IA (tumor diameter > 2 cm) to IIIA (UICC TNM Classification of Malignant Tumours, 7th edition) NSCLC. METHODS Elderly patients were randomly assigned to receive adjuvant chemotherapy for one year consisting of either alternate-day oral administration of S-1 (80 mg/m2/day) for 4 days a week (Arm A) or a daily oral administration of S-1 (80 mg/m2/day) for 14 consecutive days followed by 7-day rest (Arm B). The primary endpoint was feasibility (treatment completion rate), which was defined as the proportion of patients who completed the allocated intervention for 6 months with a relative dose intensity (RDI) of 70% or more. RESULTS We enrolled 101 patients in which 97 patients received S-1 treatment. The treatment completion rate at 6 months was 69.4% in Arm A and 64.6% in Arm B (p = 0.67). Treatment completion rate in Arm B tended to be lower compared to Arm A, as the treatment period becomes longer (at 9 and 12 months). RDI of S-1 at 12 months and completion of S-1 administration without dose reduction or postponement at 12 months was significantly better in Arm A than in Arm B (p = 0.026 and p < 0.001, respectively). Among adverse events, anorexia, skin symptoms and lacrimation of any grade were significantly more frequent in Arm B compared with Arm A (p = 0.0036, 0.023 and 0.031, respectively). The 5-year recurrence-free survival rates were 56.9% and 65.7% for Arm A and B, respectively (p = 0.22). The 5-year overall survival rates were 68.6% and 82.0% for Arm A and B, respectively (p = 0.11). CONCLUSION Although several adverse effects were less frequent in Arm A, both alternate-day and daily oral administrations of S-1 were demonstrated to be feasible in elderly patients with completely resected NSCLC. TRIAL REGISTRATION Unique ID issued by UMIN: UMIN000007819 (Date of registration: Apr 25, 2012) https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000009128. Trial ID issued by jRCT: jRCTs061180089 (Date of registration: Mar 22, 2019, for a shift toward a "specified clinical trial" based on Clinical Trials Act in Japan) https://jrct.niph.go.jp/en-latest-detail/jRCTs061180089.
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Affiliation(s)
- Hiromasa Yamamoto
- Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan
| | - Junichi Soh
- Department of Surgery, Division of Thoracic Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Norihito Okumura
- Department of Thoracic Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Hiroyuki Suzuki
- Department of Chest Surgery, Fukushima Medical University Hospital, Fukushima, Japan
| | - Masao Nakata
- Department of General Thoracic Surgery, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Toshiya Fujiwara
- Department of Thoracic Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kenichi Gemba
- Department of Respiratory Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Isao Sano
- Department of Respiratory Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Takuji Fujinaga
- Department of General Thoracic Surgery, National Hospital Organization Nagara Medical Center, Gifu, Japan
| | - Masafumi Kataoka
- Department of Surgery and Respiratory Center, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Yasuhiro Terazaki
- Department of Respiratory Surgery, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Nobukazu Fujimoto
- Department of Medical Oncology and Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan
| | - Kazuhiko Kataoka
- Department of Thoracic Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Shinji Kosaka
- Department of Thoracic Surgery, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Motohiro Yamashita
- Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Hidetoshi Inokawa
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Masaaki Inoue
- Department of Chest Surgery, Shimonoseki City Hospital, Shimonoseki, Japan
| | - Hiroshige Nakamura
- Division of General Thoracic Surgery, Tottori University Hospital, Yonago, Japan
| | - Yoshinori Yamashita
- Department of Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Katsuyuki Hotta
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Hirakata, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
| | | | - Hiroshi Date
- Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
| | - Shinichi Toyooka
- Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan
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Yang Z, Chen Y, Wang Y, Hu M, Qian F, Zhang Y, Zhang B, Zhang W, Han B. Pembrolizumab Plus Chemotherapy Versus Chemotherapy Monotherapy as a First-Line Treatment in Elderly Patients (≥75 Years Old) With Non-Small-Cell Lung Cancer. Front Immunol 2022; 13:807575. [PMID: 35237263 PMCID: PMC8882651 DOI: 10.3389/fimmu.2022.807575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/24/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Several trials have shown that pembrolizumab plus chemotherapy was more effective in patients with advanced non-small-cell lung cancer (NSCLC) than chemotherapy monotherapy. However, whether pembrolizumab plus chemotherapy is still a better choice for first-line treatment in elderly patients (≥75 years old) remain unknown. We retrospectively compared the efficacy and safety of these two treatments in elderly patients. Patients and Methods We collected data of 136 elderly patients with advanced NSCLC who were treated with pembrolizumab plus chemotherapy or chemotherapy monotherapy in our hospital from 2018 to 2020. We compared the progression-free survival (PFS) and overall survival (OS) of patients and analyzed which subgroups might benefit more significantly from pembrolizumab plus chemotherapy. Results In total population, pembrolizumab plus chemotherapy showed superior PFS and OS than chemotherapy monotherapy (PFS: 12.50 months vs. 5.30 months, P<0.001; OS: unreached vs. 21.27 months, P=0.037). Subgroup analysis showed patients with positive PD-L1 expression, stage IV, good performance score (ECOG-PS <2), fewer comorbidities (simplified comorbidity score <9) or female patients had demonstrated a more evident OS benefit in pembrolizumab plus chemotherapy. In terms of safety, the pembrolizumab plus chemotherapy group had higher treatment discontinuation (26% vs. 5%). Conclusions Elderly patients using pembrolizumab plus chemotherapy achieved longer PFS and OS, but were more likely to discontinue due to adverse effects, so disease stage, PD-L1 expression, ECOG-PS and comorbidities should be considered when selecting first-line treatment.
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Affiliation(s)
| | | | | | | | | | | | - Bo Zhang
- *Correspondence: Baohui Han, ; Wei Zhang, ; Bo Zhang,
| | - Wei Zhang
- *Correspondence: Baohui Han, ; Wei Zhang, ; Bo Zhang,
| | - Baohui Han
- *Correspondence: Baohui Han, ; Wei Zhang, ; Bo Zhang,
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Chaniad P, Trakunran K, Geater SL, Keeratichananont W, Thongsuksai P, Raungrut P. Serum miRNAs associated with tumor-promoting cytokines in non-small cell lung cancer. PLoS One 2020; 15:e0241593. [PMID: 33125430 PMCID: PMC7598461 DOI: 10.1371/journal.pone.0241593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 10/16/2020] [Indexed: 12/23/2022] Open
Abstract
Tumor-promoting cytokines are a cause of tumor progression; therefore, identifying key regulatory microRNAs (miRNAs) for controlling their production is important. The aim of this study is to identify promising miRNAs associated with tumor-promoting cytokines in non-small cell lung cancer (NSCLC). We identified circulating miRNAs from 16 published miRNA profiles. The selected miRNAs were validated in the serum of 32 NSCLC patients and compared with 33 patients with other lung diseases and 23 healthy persons using quantitative real-time PCR. The cytokine concentration was investigated using the enzyme-linked immunoassay in the same sample set, with clinical validation of the miRNAs. The correlation between miRNA expression and cytokine concentration was evaluated by Spearman’s rank correlation. For consistent direction, one up-regulated miRNA (miR-145) was found in four studies, and seven miRNAs were reported in three studies. One miRNA (miR-20a) and four miRNAs (miR-25-3p, miR-223, let-7f, and miR-20b) were reported in six and five studies. However, their expression was inconsistent. In the clinical validation, serum miR-145 was significantly down-regulated, whereas serum miR-20a was significantly up-regulated in NSCLC, compared with controls. Regarding serum cytokine, all cytokines [vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), and transforming growth factor β (TGF-β)], except tumor necrosis factor-α (TNF-α), had a higher level in NSCLC patients than controls. In addition, we found a moderate correlation between the TGF-β concentration and miR-20a (r = −0.537, p = 0.002) and miR-223 (r = 0.428, p = 0.015) and a weak correlation between the VEGF concentration with miR-20a (r = 0.376, p = 0.037) and miR-223 (r = −0.355, p = 0.046). MiR-145 and miR-20a are potential biomarkers for NSCLC. In addition, the regulation of tumor-promoting cytokine, through miR-20a and miR-223, might be a new therapeutic approach for lung cancer.
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Affiliation(s)
- Pichitpon Chaniad
- Department of Biomedical Science, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Keson Trakunran
- Department of Biomedical Science, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Sarayut Lucien Geater
- Division of Respiratory and Respiratory Critical Care Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Warangkana Keeratichananont
- Division of Respiratory and Respiratory Critical Care Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Paramee Thongsuksai
- Department of Pathology Department, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pritsana Raungrut
- Department of Biomedical Science, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- * E-mail:
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Denman AR, Groves-Kirkby CJ, Crockett RGM. Cost-effectiveness of radon remediation programmes in the UK in the 2020s. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2020; 222:106351. [PMID: 32892905 DOI: 10.1016/j.jenvrad.2020.106351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/02/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
Radon, a gaseous radioactive decay product of naturally-occurring uranium is widely distributed in the environment in rocks and soils and, in certain circumstances, can accumulate in the built environment. Initial studies confirmed a direct link between exposure to both radon gas and its short-lived radioactive progeny, and increased lung-cancer incidence, and demonstrated that radon levels in domestic housing can be sufficiently high to expose occupants to increased risk of lung-cancer. Subsequent studies worldwide have shown that it is cost-effective to detect and reduce domestic radon levels in order to reduce this risk. Recent advances in the early detection of lung-cancer, coupled with the development of improved treatment procedures, have progressively improved survival from the disease, with the numbers surviving at 5 years doubling over recent years, during which period the real costs of lung cancer treatment have risen by around 30%. In the meantime, however, in addition to radon and tobacco-smoke, other airborne pollutants have been identified as risk-factors for lung-cancer. This paper reviews both these actual developments and anticipated future trends, and concludes that since these advances in diagnosis and treatment of lung-cancer have had only a modest effect on cost-effectiveness, it is still important to conduct radon monitoring and remediation programmes. While the general increase in life-expectancy improves the cost-effectiveness of radon remediation programmes significantly, reducing tobacco-smoking incidence reduces that cost-effectiveness but with the overall benefit of reducing radon-related lung-cancers. The challenge remains of encouraging affected householders to remediate their homes to reduce radon levels.
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Affiliation(s)
- Antony R Denman
- Faculty of Arts, Science and Technology, The University of Northampton, University Drive, Northampton, NN1 5PH, UK.
| | - Christopher J Groves-Kirkby
- Faculty of Arts, Science and Technology, The University of Northampton, University Drive, Northampton, NN1 5PH, UK.
| | - Robin G M Crockett
- Faculty of Arts, Science and Technology, The University of Northampton, University Drive, Northampton, NN1 5PH, UK.
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10
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Oze I, Ito H, Nishino Y, Hattori M, Nakayama T, Miyashiro I, Matsuo K, Ito Y. Trends in Small-Cell Lung Cancer Survival in 1993-2006 Based on Population-Based Cancer Registry Data in Japan. J Epidemiol 2019; 29:347-353. [PMID: 30449770 PMCID: PMC6680055 DOI: 10.2188/jea.je20180112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/16/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Lung cancers are classified into small-cell lung cancer (SCLC) and non-small-cell lung cancer due to their different treatment and prognosis. Although many studies have reported the specific survival of SCLC patients treated at cancer hospitals, survival from population-based data has rarely been reported. METHODS We analyzed survival of SCLC cases diagnosed from 1993 through 2006 from a population-based cancer registry of six prefectures. To assess trends in SCLC survival, we defined three periods that mirrored developments in SCLC treatment: period 1, 1993-1998; period 2, 1999-2001; and period 3, 2002-2006. Assessments were based on relative survival (RS), excess hazard, and conditional survival. RESULTS A total of 10,911 SCLC patients were analyzed. Five-year RS among limited disease SCLC (LD-SCLC) in periods 1 to 3 was 16.8%, 21.1%, and 21.4%, respectively. Five-year RS among extensive disease SCLC (ED-SCLC) in periods 1 to 3 was 2.3%, 2.8%, and 2.7%, respectively. Improvement in 5-year RS in periods 2 and 3 compared with period 1 was significant among both LD- and ED-SCLC patients (all P < 0.001). Conditional 5-year RS of LD-SCLC increased from 21% at year 0 to 73% at year 5, while that of ED-SCLC was 3% at year 0 and 53% at year 5. CONCLUSIONS The prognosis of SCLC patients improved from 1999-2001 but plateaued in 2002-2006, after which no further significant improvement was seen. Continuous survey based on population-based data is helpful in monitoring the impact of developments in treatment.
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Affiliation(s)
- Isao Oze
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshikazu Nishino
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Masakazu Hattori
- Department of Cancer Therapy Center, Fukui Prefectural Hospital, Fukui, Japan
| | - Tomio Nakayama
- Division of Screening Assessment and Management, Screening Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center, Osaka Medical College, Takatsuki, Osaka, Japan
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11
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Safety and efficacy of pembrolizumab monotherapy in elderly patients with PD-L1-positive advanced non-small-cell lung cancer: Pooled analysis from the KEYNOTE-010, KEYNOTE-024, and KEYNOTE-042 studies. Lung Cancer 2019; 135:188-195. [PMID: 31446994 DOI: 10.1016/j.lungcan.2019.07.004] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/03/2019] [Accepted: 07/06/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Most lung cancer diagnoses occur in elderly patients, who are underrepresented in clinical trials. We present a pooled analysis of safety and efficacy in elderly patients (≥75 years) who received pembrolizumab (a programmed death 1 inhibitor) for advanced non-small-cell lung cancer (NSCLC) with programmed death ligand 1 (PD-L1)‒positive tumors. METHODS The pooled analysis included patients aged ≥18 years with advanced NSCLC with PD-L1-positive tumors from the KEYNOTE-010 (NCT01905657), KEYNOTE-024 (NCT02142738), and KEYNOTE-042 (NCT02220894) studies. In KEYNOTE-010, patients were randomized to pembrolizumab 2 or 10 mg/kg every 3 weeks (Q3W) or docetaxel, as second- or later-line therapy. In KEYNOTE-024 and KEYNOTE-042, patients were randomized to first-line pembrolizumab 200 mg Q3W or platinum-based chemotherapy. Overall survival (OS) was estimated by the Kaplan-Meier method, and safety data were summarized in elderly patients (≥75 years). RESULTS The analysis included 264 elderly patients with PD-L1-positive tumors (PD-L1 tumor proportion score [TPS] ≥1%); among these, 132 had PD-L1 TPS ≥ 50%. Pembrolizumab improved OS among elderly patients with PD-L1 TPS ≥ 1% (hazard ratio [HR], 0.76 [95% CI, 0.56-1.02]) and PD-L1 TPS ≥ 50% (HR, 0.40 [95% CI, 0.25-0.64]). Pembrolizumab as first-line therapy also improved OS among elderly patients with PD-L1 TPS ≥ 50% (from KEYNOTE-024 and KEYNOTE-042) compared with chemotherapy (HR, 0.41 [95% CI, 0.23‒0.73]). Pembrolizumab was associated with fewer treatment-related adverse events (AEs) in elderly patients (overall, 68.5% vs 94.3%; grade ≥3, 24.2% vs 61.0%) versus chemotherapy. Immune-mediated AEs and infusion reactions were more common with pembrolizumab versus chemotherapy (overall, 24.8% vs 6.7%; grade 3‒4: 9.4% vs 0%; no grade 5 events). CONCLUSIONS In this pooled analysis of elderly patients with advanced NSCLC with PD-L1‒positive tumors, pembrolizumab improved OS versus chemotherapy, with a more favorable safety profile. Outcomes with pembrolizumab in patients ≥75 years were comparable to those in the overall populations in the individual studies.
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12
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Hagiuda D, Nagashio R, Ichinoe M, Tsuchiya B, Igawa S, Naoki K, Satoh Y, Murakumo Y, Saegusa M, Sato Y. Clinicopathological and prognostic significance of nuclear UGDH localization in lung adenocarcinoma. Biomed Res 2019; 40:17-27. [PMID: 30787260 DOI: 10.2220/biomedres.40.17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study aimed to clarify relationships among UDP-glucose-6 dehydrogenase (UGDH) expression, clinicopathological factors, and the prognosis of patients, and to determine the role of UGDH in lung adenocarcinoma (AC). Firstly, UGDH expression and localization in 126 lung AC tissues were immunohistochemically studied, and associations with clinicopathological parameters and patients' prognosis were evaluated. Secondly, serum UGDH levels were measured in 267 lung cancer patients and 100 healthy controls. Finally, the effects of UGDH knockdown by siRNA on migration and invasion abilities were analyzed. As a result, nuclear UGDH staining was significantly correlated with poorer differentiation, a larger tumor size, higher p-TNM stage, positive nodal metastasis, positive lymphatic invasion, and positive vascular invasion in lung AC patients. Nuclear UGDH-positive patients showed significantly poorer survival than nuclear UGDH-negative patients. Serum UGDH levels were especially higher in lung AC patients even in stage I than those in healthy controls. In lung AC cell lines, nuclear expression levels of UGDH were higher in LC-2/ad cells than in A549 cells. UGDH siRNA-treated LC-2/ad cells showed significantly decreased migration and invasion abilities, but no significant differences were observed in UGDH siRNA-treated A549 cells. These data indicate that UGDH expression and localization are an early sero-diagnostic marker in addition to a poor prognostic indicator in lung AC patients.
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Affiliation(s)
- Daisuke Hagiuda
- Department of Applied Tumor Pathology, Graduate School of Medical Sciences, Kitasato University
| | - Ryo Nagashio
- Department of Applied Tumor Pathology, Graduate School of Medical Sciences, Kitasato University
| | - Masaaki Ichinoe
- Department of Pathology, School of Medicine, Kitasato University
| | - Benio Tsuchiya
- Department of Applied Tumor Pathology, Graduate School of Medical Sciences, Kitasato University
| | - Satoshi Igawa
- Department of Respiratory Medicine, School of Medicine, Kitasato University
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, School of Medicine, Kitasato University
| | - Yukitoshi Satoh
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kitasato University
| | - Yoshiki Murakumo
- Department of Pathology, School of Medicine, Kitasato University
| | - Makoto Saegusa
- Department of Pathology, School of Medicine, Kitasato University
| | - Yuichi Sato
- Department of Applied Tumor Pathology, Graduate School of Medical Sciences, Kitasato University
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13
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Fibla JJ, Molins L, Quero F, Izquierdo JM, Sánchez D, Hernández J, Bayarri C, Boada M, Guirao Á, Cueto A. Perioperative outcome of lung cancer surgery in women: results from a Spanish nationwide prospective cohort study. J Thorac Dis 2019; 11:1475-1484. [PMID: 31179090 DOI: 10.21037/jtd.2019.03.30] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background To assess possible differences in the perioperative profile between men and women in lung cancer surgery. Methods A prospective cohort multicenter study was design, in which consecutive patients undergoing curative intent surgery for lung cancer in 24 Thoracic Services throughout Spain were included. Clinical features, tumor- and surgery-related data, postoperative complications, and mortality were recorded. Results There were 2,566 men and 741 women. Women were younger than men [mean (SD) age, 61.8 (10.8) vs. 66.5 (9.1) years, P<0.0001] and showed a more favorable preoperative characteristics, with significantly higher percentages of ECOG grade 0 and lower percentages of active smokers (28.4% vs. 33.9%; pack-years 18.8 vs. 26.9) and comorbidities [chronic obstructive pulmonary disease (COPD), diabetes, hypertension, cardiac disorders]. There were significant differences (P<0.001) in histological types and TNM stages with adenocarcinoma (70.1% vs. 46.4%) and IA stage (41.5% vs. 33.6%) more frequent in women. The use of VATS or thoracotomy was similar. The rate of pneumonectomy was higher in men (10.9%) than in women (5.1%) (P<0.001) but the distributions of other procedures were similar. Postoperative complications (pneumonitis, atelectasis, air leak, hemorrhage, fistula, empyema, wound dehiscence, and need of reintubation) were lower in women. Significant differences (P<0.0001) in the severity of postoperative complications (Clavien-Dindo classification) were also found, with higher percentages of grades I (51.6% vs. 43%) and II (37.5% vs. 33%) and lower percentages of grades III and IV among women. The mean length of hospital stay was 7.8 (7.1) days in men versus 6.3 (5.0) days in women, and the 30-day mortality rate 0.3% in women versus 2.9% in men (P<0.0001). The percentage of readmissions within 30 days after surgery was also higher in men (8.6% vs. 2.8%). Conclusions This multicenter nationwide study of lung cancer surgery with curative intent shows that the perioperative profile is better in women than in men.
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Affiliation(s)
- Juan J Fibla
- Department of Thoracic Surgery, Hospital Universitari del Sagrat Cor, Barcelona, Spain
| | - Laureano Molins
- Department of Thoracic Surgery, Hospital Universitari del Sagrat Cor, Barcelona, Spain.,Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain
| | - Florencio Quero
- Department of Thoracic Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - José Miguel Izquierdo
- Department of Thoracic Surgery, Hospital Universitario Donostia, San Sebastián, Spain
| | - David Sánchez
- Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain
| | - Jorge Hernández
- Department of Thoracic Surgery, Hospital Universitari del Sagrat Cor, Barcelona, Spain
| | - Clara Bayarri
- Department of Thoracic Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Marc Boada
- Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain
| | - Ángela Guirao
- Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain
| | - Antonio Cueto
- Department of Thoracic Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain
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14
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Yamaguchi T, Nishiura H. Predicting the Epidemiological Dynamics of Lung Cancer in Japan. J Clin Med 2019; 8:jcm8030326. [PMID: 30857126 PMCID: PMC6463119 DOI: 10.3390/jcm8030326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/19/2019] [Accepted: 03/05/2019] [Indexed: 12/17/2022] Open
Abstract
While the prevalence of smoking has steadily declined over time, the absolute numbers of lung cancer cases and deaths have continued to increase in Japan. We employed a simple mathematical model that describes the relationship between demographic dynamics and smoking prevalence to predict future epidemiological trends of lung cancer by age and sex. Never-smokers, smokers, and ex-smokers were assumed to experience different hazard of lung cancer, and the model was parameterized using data from 2014 and before, as learning data, and a future forecast was obtained from 2015 onwards. The maximum numbers of lung cancer cases and deaths in men will be 76,978 (95% confidence interval (CI): 76,630⁻77,253) and 63,284 (95% CI: 62,991⁻63507) in 2024, while those in women will be 42,838 (95% CI: 42,601⁻43,095) and 32,267 (95% CI: 32,063⁻32,460) in 2035 and 2036, respectively. Afterwards, the absolute numbers of cases and deaths are predicted to decrease monotonically. Our compartmental modeling approach is well suited to predicting lung cancer in Japan with dynamic ageing and drastic decline in smoking prevalence. The predicted burden is useful for anticipating demands for diagnosis, treatment, and care in the healthcare sector.
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Affiliation(s)
- Takayuki Yamaguchi
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan.
- CREST, Japan Science and Technology Agency, Honcho 4-1-8, Kawaguchi, Saitama 332-0012, Japan.
| | - Hiroshi Nishiura
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan.
- CREST, Japan Science and Technology Agency, Honcho 4-1-8, Kawaguchi, Saitama 332-0012, Japan.
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15
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Sato K, Saiki Y, Arai K, Ishizawa K, Fukushige S, Aoki K, Abe J, Takahashi S, Sato I, Sakurada A, Okada Y, Horii A. S100A10 upregulation associates with poor prognosis in lung squamous cell carcinoma. Biochem Biophys Res Commun 2018; 505:466-470. [PMID: 30268496 DOI: 10.1016/j.bbrc.2018.09.118] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 09/19/2018] [Indexed: 01/10/2023]
Abstract
S100A10 is one of the members of the S100 protein family and is a key plasminogen receptor. Its upregulation has been reported in many types of tumors. In lung cancer, an association between upregulation of S100A10 and poor prognoses has been reported only in adenocarcinoma. We pursued the possibility of significance in lung squamous cell carcinoma (SCC). We first examined S100A10 protein expression by immunohistochemistry in 120 primary resected lung SCCs; 33 (27.5%) tumors showed strong membranous-immunopositivity particularly at the invasive front, i.e., the cancer-cell surface in contact with the stroma. Expression levels were significantly associated with higher pathological TNM stage (P = 0.0119), tumor size (P = 0.0003), lymphatic invasion (P = 0.0005), lymph node metastasis (P = 0.0006), and poorer prognosis (P = 0.0064). Our present results suggest that high S100A10 expression of the lung SCC cells, particularly adjacent to stroma, plays an important role in tumor progression, probably caused by lymphatic invasion and nodal metastasis.
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Affiliation(s)
- Kimiaki Sato
- Department of Molecular Pathology, Tohoku University School of Medicine, Sendai, Miyagi, Japan; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Yuriko Saiki
- Department of Molecular Pathology, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Kazumori Arai
- Department of Pathology, Shizuoka General Hospital, Shizuoka, Shizuoka, Japan
| | - Kota Ishizawa
- Department of Molecular Pathology, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Shinichi Fukushige
- Department of Molecular Pathology, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Kenko Aoki
- Department of Molecular Pathology, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Jiro Abe
- Department of Thoracic Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Satomi Takahashi
- Department of Thoracic Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Ikuro Sato
- Department of Pathology, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Akira Sakurada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Yoshinori Okada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Akira Horii
- Department of Molecular Pathology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
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Li X, Dai D, Chen B, Tang H, Xie X, Wei W. Determination of the prognostic value of preoperative CA15-3 and CEA in predicting the prognosis of young patients with breast cancer. Oncol Lett 2018; 16:4679-4688. [PMID: 30214602 DOI: 10.3892/ol.2018.9160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 12/07/2017] [Indexed: 01/29/2023] Open
Abstract
To the best of our knowledge, no previous study has investigated the association of carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) with the prognosis for young patients (≤40 years) with breast cancer. In the present study, preoperative CEA and CA15-3 serum levels were evaluated in the prediction of the prognosis for young patients with breast cancer. In total, 699 patients were recruited, for which the CEA and CA15-3 serum levels had been measured prior to surgery via a blood sample. The optimal cut-off high and low values were determined using receiver operating characteristic curve analysis and Youden's index. The value of CEA and CA15-3 in predicting overall survival (OS) and disease-free survival (DFS) were measured using univariate and multivariate Cox's regression analyses. The cut-off values were 3.38 ng/ml and 12.32 U/ml for CEA and CA15-3, respectively. It was identified that CEA, but not CA15-3, was a predictor for the prognosis of the young patients with breast cancer. Multivariate analysis confirmed that CEA, but not CA15-3, was an independent prognostic marker for all young patients with breast cancer. In total, 623 young patients exhibited decreased levels of CEA; in these patients, CA15-3 with a cut-off value of 12.48 U/ml was an independent prognostic factor for OS and DFS. Preoperative serum CEA may thus serve as an independent predictor of poor prognosis for young patients with breast cancer. However, for low-risk patients with decreased CEA levels, serum CA15-3 may supplement the prediction of overall prognosis.
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Affiliation(s)
- Xuan Li
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Danian Dai
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Bo Chen
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Hailin Tang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Xiaoming Xie
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Weidong Wei
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
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17
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Shirai K, Abe T, Saitoh JI, Mizukami T, Irie D, Takakusagi Y, Shiba S, Okano N, Ebara T, Ohno T, Nakano T. Maximum standardized uptake value on FDG-PET predicts survival in stage I non-small cell lung cancer following carbon ion radiotherapy. Oncol Lett 2017; 13:4420-4426. [PMID: 28588712 DOI: 10.3892/ol.2017.5952] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 02/17/2017] [Indexed: 12/29/2022] Open
Abstract
The present study (University Hospital Medical Information Network study no. UMIN000003797) aimed to evaluate whether the maximum standardized uptake value (SUVmax) of pretreatment 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) is prognostic factor for stage I non-small cell lung cancer (NSCLC) treated with carbon ion radiotherapy (C-ion RT). Patients treated between June 2010 and June 2013 at Gunma University Heavy Ion Medical Center (Maebashi, Japan) on a prospective protocol were included in the present study. Patients with T1a-b and T2a NSCLC were treated with C-ion RT at a dose of 52.8 Gy [relative biological effectiveness (RBE)] and 60.0 Gy (RBE), respectively, in four fractions. Prior to treatment, all patients underwent FDG-PET, in which the SUVmax of primary tumors was evaluated. Local control, progression-free survival (PFS), and overall survival (OS) were calculated. A total of 45 patients were analyzed and the median follow-up period was 28.9 months. The 2-year local control, PFS and OS rates for all patients were 93, 78 and 89%, respectively. The mean SUVmax of primary tumors was 5.5, and patients were divided into higher (≥5.5) and lower (<5.5) SUVmax groups. The 2-year PFS rates were 61 and 89% for the higher and lower SUVmax groups, respectively (P=0.01), and the 2-year OS rates for the higher and lower SUVmax groups were 76 and 96%, respectively (P=0.01). The higher SUVmax group exhibited a significantly worse PFS and OS compared with the lower SUVmax group; however, the SUVmax was not associated with the local control rate. In total, 2 patients (4%) experienced grade 2 or 3 radiation pneumonitis, with their symptoms improved through conservative treatment. No patients experienced any grade 4 or 5 toxicities. The results of the present study indicate that pretreatment SUVmax is a prognostic indicator for outcomes in patients with stage I NSCLC treated with C-ion RT.
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Affiliation(s)
- Katsuyuki Shirai
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
| | - Takanori Abe
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
| | - Jun-Ichi Saitoh
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
| | - Tatsuji Mizukami
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
| | - Daisuke Irie
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
| | - Yosuke Takakusagi
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
| | - Shintaro Shiba
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
| | - Naoko Okano
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
| | - Takeshi Ebara
- Department of Radiation Oncology, Gunma Prefectural Cancer Center, Ota, Gunma 373-8550, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
| | - Takashi Nakano
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan
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18
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Hirata M, Nagai A, Kamatani Y, Ninomiya T, Tamakoshi A, Yamagata Z, Kubo M, Muto K, Kiyohara Y, Mushiroda T, Murakami Y, Yuji K, Furukawa Y, Zembutsu H, Tanaka T, Ohnishi Y, Nakamura Y, Matsuda K. Overview of BioBank Japan follow-up data in 32 diseases. J Epidemiol 2017; 27:S22-S28. [PMID: 28190660 PMCID: PMC5363789 DOI: 10.1016/j.je.2016.12.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 12/15/2016] [Indexed: 01/23/2023] Open
Abstract
Background We established a patient-oriented biobank, BioBank Japan, with information on approximately 200,000 patients, suffering from any of 47 common diseases. This follow-up survey focused on 32 diseases, potentially associated with poor vital prognosis, and collected patient survival information, including cause of death. We performed a survival analysis for all subjects to get an overview of BioBank Japan follow-up data. Methods A total of 141,612 participants were included. The survival data were last updated in 2014. Kaplan–Meier survival analysis was performed after categorizing subjects according to sex, age group, and disease status. Relative survival rates were estimated using a survival-rate table of the Japanese general population. Results Of 141,612 subjects (56.48% male) with 1,087,434 person-years and a 97.0% follow-up rate, 35,482 patients died during follow-up. Mean age at enrollment was 64.24 years for male subjects and 63.98 years for female subjects. The 5-year and 10-year relative survival rates for all subjects were 0.944 and 0.911, respectively, with a median follow-up duration of 8.40 years. Patients with pancreatic cancer had the least favorable prognosis (10-year relative survival: 0.184) and patients with dyslipidemia had the most favorable prognosis (1.013). The most common cause of death was malignant neoplasms. A number of subjects died from diseases other than their registered disease(s). Conclusions This is the first report to perform follow-up survival analysis across various common diseases. Further studies should use detailed clinical and genomic information to identify predictors of mortality in patients with common diseases, contributing to the implementation of personalized medicine. 141,612 participants with any of 32 diseases were included in the follow-up survey. Subject characteristics at enrollment for the follow-up survey were identified. The relative survival analysis showed the worst prognosis in pancreatic cancer. The most common cause of death in all subjects was malignant neoplasms.
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Affiliation(s)
- Makoto Hirata
- Laboratory of Genome Technology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Akiko Nagai
- Department of Public Policy, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, University of Yamanashi, Yamanashi, Japan
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Kaori Muto
- Department of Public Policy, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yutaka Kiyohara
- Hisayama Research Institute for Lifestyle Diseases, Fukuoka, Japan
| | - Taisei Mushiroda
- Laboratory for Pharmacogenomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yoshinori Murakami
- Division of Molecular Pathology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Koichiro Yuji
- Project Division of International Advanced Medical Research, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yoichi Furukawa
- Division of Clinical Genome Research, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hitoshi Zembutsu
- Laboratory of Molecular Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Division of Genetics, National Cancer Center Research Institute, Tokyo, Japan
| | - Toshihiro Tanaka
- SNP Research Center, RIKEN Yokohama Institute, Yokohama, Japan; Department of Human Genetics and Disease Diversity, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Bioresource Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yozo Ohnishi
- SNP Research Center, RIKEN Yokohama Institute, Yokohama, Japan; Shinko Clinic, Medical Corporation Shinkokai, Tokyo, Japan
| | - Yusuke Nakamura
- Laboratory of Molecular Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, USA
| | | | - Koichi Matsuda
- Laboratory of Molecular Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Laboratory of Clinical Genome Sequencing, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan.
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